Category: CC-Vascular

Billing Diagnostic Angiograms with an Intervention
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Billing Diagnostic Angiograms with an Intervention

July 11, 2019 Question: When are diagnostic angiograms and an intervention (angioplasty, stent, etc) both billable? Answer: Diagnostic angiograms are separately billable during an intervention if no adequate, prior adequate angiogram exists. Code diagnostic angiograms only if: no previous angiogram is available, the prior angiogram is not adequate to diagnose the disease, or the patient’s...

Coding TCAR
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Coding TCAR

June 20, 2019 Question: What is TCAR and how is it coded? Answer: TCAR stands for Transcarotid Artery Revascularization.  It is essentially an open carotid stent procedure. A small incision is made just above the collar bone to expose the common carotid artery. A sheath is placed directly into the carotid artery and connected to...

OOOPs. I nicked a vessel. Can I bill for repairing it?
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OOOPs. I nicked a vessel. Can I bill for repairing it?

May 23, 2019 Question: The surgeon accidentally nicked a vessel not involved in the bypass being performed, can he bill for repair of vessel since he had to repair it? Answer: Iatrogenic, intraoperative complications that are repaired at the same operative session are not separately reported. Since the vessel laceration was an iatrogenic injury, inadvertently...

E-Consults?
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E-Consults?

April 11, 2019 E-Consults? Question: One of my colleagues told me that she was doing e-consults with other physicians for Medicare and getting paid.  Is this a billable service? Answer: Yes!  Medicare has added CPT codes 99446-99452 for interprofessional/ telephone/internet/electronic health record (EHR) consultations to the fee schedule, so they are now payable services.  These...

Modifier 78 vs 59
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Modifier 78 vs 59

March 28, 2019 Question: What modifier do we use if a patient is returned to the OR the same day as the original surgery for post-op hemorrhage? Isn’t it 78 for this complication? Answer: Modifier 78 is a global period modifier and the global period begins on post-op day one. So it is not appropriate...

Global Period for Debridement
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Global Period for Debridement

March 14, 2019 Question: I thought the global period of debridement of muscle or bone was 10 days. Is that true?  Answer: The debridement codes were revised in 2011 and the global period for all codes (11042-11047) was revised to 0 days. *This response is based on the best information available as of 3/14/19.

Debridement Coding
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Debridement Coding

February 28, 2019 Question: If 10 sq. cm subcutaneous tissue is debrided from the right leg and 20 sq. cm is debrided from the left leg, is it coded as 11042 and 11042-59 or 11042 RT and 11042 LT? Answer: If debridement is performed at the same depth of tissue (all subcutaneous tissue) it is...

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