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  1. J

    Wiki global surgery

    Modifier not needed.
  2. J

    Wiki LHC

    93459, but why was the leg imaged? Could have done doppler imaging?
  3. J

    Wiki Sclerotherapy code 93971 UHC denial

    Ultrasound is bundled into sclerotherapy injections. 93970 and 93971 are mapping procedures and not billable during interventional procedures. HTH, Jim
  4. J

    Wiki LATERALITY MOD ON CENTRAL LINE PLACEMENT?

    The third party payer want the laterality modifier. So I code 36561-rt for a right sided mediport insertion. HTH, Jim
  5. J

    Wiki 95967....59 mod on subsequent 95967's?

    CPT says for each additional modality, so I say yes you can. HTH, Jim
  6. J

    Wiki pericardiocentesis

    33016 - Pericardiocentesis - includes imaging guidance if performed. That should answer the question. HTH, Jim
  7. J

    Wiki What is the cpt code for bilateral tPA infusion for PE

    I hope the modifier -50 was added to 36014.
  8. J

    Wiki NEED HELP WITH ALL THESE EMBOLIZATIONS IM CONFUSED

    I agree with 37242 and 75726. The lt gastric to the rt hepatic is coded 36247 There is no 36245 or 36246 as there is no support for the codes from the dictation. No imaging for the u/s vasc. access, so no 76937. HTH, Jim
  9. J

    Wiki embolization help

    I agree with 37242 and 76937. Since he started in the posterior tibial artery, I would code 36245 x 2 for the genicular arteries, no 75710 as this is not a diagnostic exam.
  10. J

    Wiki emborrhoid procedure help

    37224 - Embolization for arterial bleeding 36247 - 3rd order selective - superior rectal artery 36248 - selective 2nd or 3rd order after the basic - at least 5 of these vessels is catheterized with a 2.4 microcatheter, however they are not named arteries. When they are not named you give them 2...
  11. J

    Wiki emborrhoid procedure help

    I would code 37244, 36247, 36248 x 2, 75726, 75774 x 2. Would not code 76937 as no U/S image was saved. Question back to you, where did you get 36245? HTH, Jim
  12. J

    Wiki NUMBER OF GUIDANCE CODES FOR RT & LT JUGULAR LINES

    MUE is two for these codes, so I would code 36556-50, 76937-50 and 77001-50. You may have to code them separately with a modifier rt & lt with 59, depending on payer. HTH, Jim
  13. J

    Wiki Nephrostogram by Xray Tech?

    They changed the codes a few years ago and bundled 74425 into the codes. It is still billable on one code. That is injecting of a urethral catheter via ileal conduit.
  14. J

    Wiki CTI then DCCV

    Only if the cardioversion was before the intervention.
  15. J

    Wiki Nephrostogram by Xray Tech?

    Your billing for the doctor, who is interpretating the films. 74425 has been deleted from the nephrostogram, so you code 50431 for the procedure. And don't worry about the tech doing the procedure. I have done nephrostograms with the doctor in the room watching over me. Jim Pawloski, R.T. (CV)...
  16. J

    Wiki Nephrostogram a few days later?

    You code 50431 for the nephrostogram, 75774 has been deleted from that charge. When an intervention has been done after nephrostogram, like a tube change, then the nephrostogram is bundled in the change. HTH, Jim
  17. J

    Wiki Need Help with Renal Artery Stent coding

    What I see that you are missing is C1876, for the stent. Simply, if you did any angioplasty, you need an angioplasty catheter. If you placed a stent, you need a stent code. Looking at all your codes, after you add C1876, you should be good on appeal. HTH, Jim
  18. J

    Wiki Need Help with Renal Artery Stent coding

    Where was the stent placed? You coded a Coronary angiogram with grafts for your basic code, then coded a vascular stent placement. You should be looking at the codes 92920 to 92979 and the C-codes for your intervention. HTH, Jim
  19. J

    Wiki Pulmonary angio

    Looks good to me! Jim
  20. J

    Wiki Carotid angio

    I would code 36223-50 for the carotids, and 36225-50 for the vertebrals. HTH, Jim
  21. J

    Wiki Aspiration thrombectomy of pulmonary arteries

    This is what you need to do. So what was done is a thrombectomy of the pulmonary artery on both sides. So you code that with a modifier -50. You can also code for the catheter position. There's no report if a CTA of the Chest, if there is, you can't report the pulmonary arteriogram - bilateral...
  22. J

    Wiki Pulmonary angio and thrombectomy

    After reviewing this case, this is how I would code it. 37184-50 for the bilateral thrombectomy, 36015-50 for the catheterization, 37252 and 37253 for the IVUS, 76937 and 99152. I would not code 93451 as there is no documentation of the Right Heart Cath. Pressures are bundled into the...
  23. J

    Wiki Coronary Angiography

    It doesn't matter if the physician doesn't indicate if a CABG will happen. So basically, if the mammary artery is injected, code for grafts- either 93455 or 93459. My best resource is Z-Health Publishing. The books are on the expensive side however it is a great resource. MedLearn is also...
  24. J

    Wiki Coronary Angiography

    If the patient has coronary artery disease and may go have a CABG, the internal mammary artery may be used for bypass. That is when 93459 can be used. The iliac artery was probably closed with a closure device, so the imaging is bundled in the procedure. HTH, Jim
  25. J

    Wiki WATCHMAN EXPLANT

    I think your using an unlisted code.
  26. J

    Wiki Repairs, Stents, Patches

    I would use the Z-code for previously done . HTH, Jim
  27. J

    Wiki Roadmapping or billable?

    I would go with the roadmap since there was difficulty in getting thru the subclavian artery. HTH, Jim
  28. J

    Wiki Renal stent coding, help.

    I like your option # 3. 37252 can only be used once along with 36236, as in one vessel. So the other vessels are covered with 37253 and 36237. HTH, Jim
  29. J

    Wiki 34713's Help

    Since you are asking about an aorto-bi-iliac graft, what happened to the left side? Do we have access to the left femoral artery? If so then you should have coded 34713-50-62 since a 12 french sheath was placed and that is the lower limit. HTH, Jim
  30. J

    Wiki Breast MRI screening ICD-10 codes.

    Are you using Z12.31?
  31. J

    Wiki Sel Bil Pulm Angio w/ aspiration thrombectomy

    You selected the correct codes, and I agree with 37184, there is no documentation of thrombectomy. HTH, Jim
  32. J

    Wiki Y90 help

    If mAA is injected, it is a mapping procedure for what vessel is feeding the tumor. Y-90 is the embolization procedure.
  33. J

    Wiki IVUS 92978 discontinued?

    You have no findings, so I would not code for IVUS.
  34. J

    Wiki Y90 CPT codes

    I don't see any documentation to support 36248. Just the Left hepatic artery was selected. Don't be surprised if 75726, 75774 and 74175 doesn't get paid as the same vessels were selected during the mAA study without any embolization performed. It would be considered roadmapping which is not...
  35. J

    Wiki Microcatheterization of middle meningeal artery

    36228 is for the diagnostic exam. Code for your catheter placement - 36217 probably anlong with the embolization code.
  36. J

    Wiki RHC w/ thermodilution and Fick

    Check CPT under Heart Catheterization, then Right heart catheterization.
  37. J

    Wiki Help with Pulmonary Thrombolysis coding

    Yes, I would use 37221 then.
  38. J

    Wiki Fibrin sheath disruption

    Fibrin sheath disruption with balloon dilation remains an unlisted procedure (37799), along with the 36581 and 77001 for the tunneled catheter exchange. There have been no changes to these society recommendations. Do not report 37248 (venoplasty) when balloon disruption of a fibrin sheath is...
  39. J

    Wiki RHC w/ thermodilution and Fick

    Yes, all of the above is part of 93451.
  40. J

    Wiki Help with Pulmonary Thrombolysis coding

    Can't use 37211 because that is an infusion thrombolysis, even though TPA was given (has to be infused over a few hours). I would code 37184-50 along with the codes you posted. HTH
  41. J

    Wiki does this need a modifier 59

    I would put the modifier -59 on 93653.
  42. J

    Wiki transforaminal pain injection

    Tell them to read the last two words of 96372. Subcutaneous or intramuscular. I know they are not doing that. HTH, Jim
  43. J

    Wiki Billing pacemakers/ICD's/physiology monitors

    I would try billing for it in the 4-6 day window, as the patient's availability for the check may interfere with 90 day rule.
  44. J

    Wiki Billing pacemakers/ICD's/physiology monitors

    I hope I can help you. First, the service center is where the procedure was done, example, hospital, office-based labs (OBL), off-campus outpatient hospital. As for the other procedures, you can bill for the pacemaker insertion just after the procedure is performed. It's the pacemaker/ICD...
  45. J

    Wiki Coil Embolization

    And the same to you!!!
  46. J

    Wiki Coil Embolization

    Here I come to save the day!! :D I agree with your codes, except for the angiography code. I would code that 75736 because the catheter was in the internal iliac system, so that is why I chose 75736. There is no documentation for a lower leg arteriogram. HTH, Jim
  47. J

    Wiki Repair of gastrotomy tube

    Code either the unlisted procedure, or a low level E&M code. HTH, Jim
  48. J

    Wiki need help with modifier- xu or 59 with diagnostic cath and pci same day

    It depends on the third-party payer. Go with what you think is right until the third party payer corrects you. HTH, Jim
  49. J

    Wiki need help with pocket revision cpt because of hematoma

    I would code 10140 - Incision and drainage of hematoma, seroma, or fluid collection. HTH, Jim
  50. J

    Wiki Bi V Pacer coding for ASC

    I would code 33224 since the generator is the generator that was in the patient, not a new generator. FYI, the C-code is for hospital use only. HTH, Jim
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