Search results

  1. M

    Wiki Anatomical charts

    I only use Dr. Z and Medlearn as they both work directly with AMA, ACR, and SIR to ensure all information they use and publish is supported by guidance/instruction set forth by one (or more) of those entities. We found way too many inconsistencies and misinterpretations of rules and guidelines...
  2. M

    Wiki Career in IR

    Peggy, Almost every specialty has different "rules" and both IR and cardiovascular surgery are particularly challenging areas. I have both AAPC's IR certification as well as an IR certification from a different vendor and can attest that the other vendor's certification and program focused...
  3. M

    Wiki Cardiothoracic Book

    AMA's CPT Reference Guide for Cardiovascular Coding includes cardiothoracic coding and Dr. Z's has one as well, both are really good.
  4. M

    Wiki ready to throw in the towel

    Bugsy, I have a few positions available for remote physician billing. I am in need of an experienced coder who is able to handle high volume work in a fast paced setting. We desire someone with a background in interventional radiology and/or vascular surgery coding (and must be able to prove...
  5. M

    Wiki 76831 SIS Hysterosonography Interpretation

    See if this helps you any. If you still need more info just let me know!
  6. M

    Wiki Certified Credentialer

    We have a certified credentialer available for remote/contract work. She has been with her current employer for 14 years however they have decided to shut down due to insurance budget cuts. I will forward her resume' to anyone who is interested!
  7. M

    Wiki IVR Coding charts

    Darla, Send me your email that you wish to receive coorespondence and I will forward/share the 2010 charts from SIR (Society of Interventional Radiology). Medlearn has a IVR coding guide...is that what you are looking for or for the color-coded charts?
  8. M

    Wiki Radiologist Intraoperative Fluro Coding

    If you are billing the professional component then you bill for what was read unless your doc is not providing a diagnostic interp. If the reports just states "films were obtained in OR and presented to radiology dept" or if the report says "films were presented from OR and all is normal" then...
  9. M

    Wiki azygos venogram

    This was just posted on the RBMA (Radiology Business Managers Association) coding forum regarding the azygos vein imaging. There are 2 different posts, one from 10/1/10 & the other from 8/3/10. --------------------------------------------------------------------------------------------- From...
  10. M

    Wiki azygos venogram

    Depends....where was the initial puncture? Were there more catheterizations besides the azygos? In most cases the only code you could use for the RS&I portion would be 75774 (selective VESSEL-which SHOULD cover both arteries & veins however not all insurance companies agree with that). Without...
  11. M

    Wiki Enterocutaneous Fistula Plug

    This may not be the same thing as your procedure bu this was just posted on the RBMA (Radiology Business Managers Association) Coding Forum. Walt Blackham is on the AMA board and several other boards. Subject: Re: Enterocutaneous Fistula Closure UPC for the closure and 20501+ 76080 for...
  12. M

    Wiki Sclerotherapy

    IMHO, I do not feel that they performed or dictated a true diagnostic venography. The way the dictation reads, the contrast injections were only performed as assurance that the sheaths/caths were in the appropriate vein before they injected the ethanol. In order to consider charging a venogram...
  13. M

    Wiki Sclerotherapy

    Sclerotherapy for venous malformation (which the report provided by Girish indicates), lymphangioma, hepatic cyst, seroma, abscess obliteration, etc. is billed as a UPC. Kathryn-why was your procedure performed? Spider veins? Varicose veins? Any type of varicosities? Or one of the reasons...
  14. M

    Wiki c6-c7 bx

    Not that 10022 would be considered incorrect in the event of an audit but CPT 62267 describes what was performed as well. 10022 is a "general" aspiration CPT whereas 62267 is specifically designated for the disc aspiration/biopsy. Since the RVUs for 62267 are double that of 10022 I'd say that...
  15. M

    Wiki c6-c7 bx

    63615 is performed under stereotactic guidance and since this report says CT guidance you couldn't use this code. Plus if you read the surgical description for 63615 (see below) it doesn't look like what was performed at all.....look at it and tell me what you think. 63615 Stereotactic...
  16. M

    Wiki c6-c7 bx

    62267/77012 sounds like what was performed....
  17. M

    Wiki hepatic cyst aspiration and sclerosis

    You would code 47011/75989 for the aspiration and 47399 (or 49999) for the sclerotherapy.:)
  18. M

    Wiki Ct lower extremities code 73710

    73700-73702 are unilateral codes so yes, you would bill it twice for a bilateral exam. as for which modifier to use, it's a toss up! Each carrier is different...some ask for RT/LT mods while others request a 76 mod be submitted and even though this code is not approved for a 50 mod I have...
  19. M

    Wiki Help with a Spine embo case

    Liza, Assuming a femoral approach was utilized you would code 75705x11, 36215x11, 37204, 75894, & 75898. The pulmonary arteries are mentioned in the top of the report however the body of the report does not support selective cath and a true diagnostic study of bilat pulmonary arteries so I...
  20. M

    Wiki Modifier 52 on G0202/77057

    Anyone out there receiving denials from Palmetto GBA when submitting a claim for a unilateral SCREENING mammogram (G0202/77057) with a 52 modifier? The carrier has instructed us to change the CPT to G0206/77055 (unilateral diagnostic) and resubmit without a 52 which we know is incorrect and goes...
  21. M

    Wiki endovascular AV fistula procedure

    Maddie, Per the 2010 SIR (Society of Interventional Radiology) Supplment Guide, you should only bill the 35476/75978. See page 11....if you do not have it then let me know and I'll forward it to you in case you need it!
  22. M

    Wiki Cpt 79005

    Ahhh....well that makes more sense however the provider is mistaken. This CPT can be billed with a 26 or TC unless you are billing globally. The national Medicare Fee Schedule has this CPT broken down in Global allowable, Professional allowable, & Technical allowable as well which only further...
  23. M

    Wiki localization

    You cannot code for a biopsy since there's nothing in the rpeort to state a biopsy was performed. You will have to use an unlisted procedure code.
  24. M

    Wiki Cpt 79005

    Why would you need to? There's not a NCCI edit in effect for this CPT......
  25. M

    Wiki Biliary Exchange question

    Definitely! Maybe there's something somewhere on the report that may indicate the intent of the exam/procedure and clear up several questions....I hope!
  26. M

    Wiki Biliary Exchange question

    This is a complete shot in the dark here...but to me it sounds like the external biliary cath was removed and a guidewire placed just to keep the site opened and to keep the cath from being in the way before the patient went to the OR for their GI stent procedure and then returned to the IR...
  27. M

    Wiki 61623 and then 61624

    The last article I have on this subject (2003 Insider's View) provides guidance on this specific scenario and states that 61623 would be inherent to the 61624 however the most recent Medlearn IR seminar I attended provided opinion stating that in very rare cases it would be acceptable to bill...
  28. M

    Wiki Kyphoplasty

    In one session or in a lifetime?
  29. M

    Wiki 77002/77003 require permanent stored images?

    There is nothing in the CPT descriptor nor from ACR stating that there need (or have) to be perm/stored/archived images for 77002/77003. There is info stating that 76937 (and 77001 per ACR) must have perm/stored/archived images though.
  30. M

    Wiki femoral catheter for dialysis?

    Tunneled or non-tunneled? Port or reservoir? Is patient under 5 yrs of age or older? Look at CPTs 36556-36568 for coding on the femoral dialysis cath, also use 76937 if perm images were obtained under ultrasound guidance and stored/archived in patient's medical chart, and 77001 if fluoroscopy...
  31. M

    Wiki Drainage of Pneumoperitoneum

    Look at 49420. It says that it is for drainage but does not specify that it has to be fluid. Also, the descriptor says that the cath or cannula could be placed percutaneously or via surgical incision. Without seeing the report it's difficult to know the most appropriate code but maybe this will...
  32. M

    Wiki Academic Hospital Billing

    Is there anyone out there who bills for an academic hospital (training hospital for NP, PA, resident docs, etc.)?
  33. M

    Wiki thyroid ablation

    60699 & 76940 is it's for the professional component.....there is not a code for thyroid ablation so you would have to use a UPC. Hope this helps!
  34. M

    Wiki 76098 specimen via radiology and u/s

    Shar, You can charge 76098 for the radiograph however u/s of a specimen is not covered under 76098. You would have to bill a UPC for that specimen. And yes, you definitely can charge twice for the same specimen if performed under2 different techniques. Hope this helps!
  35. M

    Wiki Filter Type Embolic Protection Devices

    If you are billing the pro fee side then no, there is nothing extra you can charge for the work since it's considered inherent to the embolization procedure. If being used in carotid stenting (CPT 37215) then it's included in the reimbursement. If you are billing for the techincal portion then...
  36. M

    Wiki Mri defacogram

    Most likely just a noncontrast pelvic MRI if you're doing physician billing.....there are very few centers who perform these and normally it's just a pelvic MRI performed after contrast injection via rectum to check for anal/rectal and pelvic floor muscle functionality...unless your facility is...
  37. M

    Wiki Renal cyst aspiration and ethanol inj

    In my opinion, I would use 76942/50390. The 74470 code is for a contrast evaluation which is not supported by the documentation provided. The only other code that I've seen suggested for ethanol injection was 53899 (UPC) however 50390 covers both aspiration &/or injection so it's your best option.
  38. M

    Wiki Esophageal Fistula Repair - Several of our coders are experiencing

    All, Several of our coders are experiencing a difference of opinions when coding the attached report. I wanted a few unbiased opinions..any takers??? Thanks!
  39. M

    Wiki Esophageal Fistula Repair - Several of our coders have a difference

    Several of our coders have a difference of opinion how to code the following report. Instead of providing the different codes from each coder I want to see what other people come up with. Thanks Everyone!!
  40. M

    Wiki FNA vs biopsy

    Not necessarily. I am assuming you are billing for the physician however if you are not please disregard what I am about to say...... Excerpt from 2009 Medlearn IR Coder- "As a rule of thumb: an aspirational biopsy sample is sent to pathology for cytologic examination; a core biopsy sample is...
  41. M

    Wiki Psoas Muscle Abscess Drainage

    My apologies for the delayed response, I tend to forget to check back in to see if there has been a reply! I do not disagree that a psoas muscle abscess is in the retro area and could be considered as a retroperitoneal abscess however when choosing a CPT we are instructed to choose the CPT that...
  42. M

    Wiki Psoas Muscle Abscess Drainage

    The reason for the exam was for a psoas MUSCLE abscess which would be coded as 75989 & 20000. The report does not state that the cath was placed within the retropertioneal cavity nor does it support a retroperitoneal infection so I disagree with coding 75989 & 49061
  43. M

    Wiki Pet ct modifiers pi / ps

    Heidi, The effective date for the new modifiers has been changed several times and the last date posted was 8/15/09 however CMS stated that everyone should check with their local carrier for specific rules & dates. I sent you the CMS transmittal with the most current rules & it lists the...
  44. M

    Wiki Contrast Injection thru Suprapubic Catheter

    49424 is for a cath check of an abscess or cyst drainage tube so I would be extremely reluctant to use that with this type of procedure unless your documentation specifically stated that the suprapubic cath was placed for an abscess/cyst drainage purpose. The lay description for CPT 51600...
  45. M

    Wiki Contrast Injection thru Suprapubic Catheter

    Suprapubic caths are generally placed from outside of the body into the bladder so, yes, they should be the same unless the report indicates otherwise.
  46. M

    Wiki Motility tubes

    Sounds like a GJ tube exchange except they are using 2 different approaches.
  47. M

    Wiki Venography help needed!

    Only code the angioplasty once per operative field. The report does not support multiple operative fields for the interventional portion so I wouldn't charge it twice. The rest of your codes are correct.
  48. M

    Wiki Contrast Injection thru Suprapubic Catheter

    Try looking at 51600/74430
  49. M

    Wiki Allergic reaction to CT Contrast

    Are you just looking for the HCPCS code? If so then you would bill J2920 for up to 40mg of Solu-Medrol or J2930 for up to 125mg (41mg-125mg). If you're asking if you can charge for both the contrast & Solu-Medrol...it has an ASC pymt indicator of N1 stating that it's a packaged/service item with...
  50. M

    Wiki Embolization - How will you code for bilateral

    You are correct, it is per operative field.
Top