Category: CC-Vascular

Reporting 75630 with Extremity Angiograms
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Reporting 75630 with Extremity Angiograms

December 2, 2021 Question: Can code 75630, aortogram, be reported with a unilateral or bilateral extremity angiogram (75710 of 75716)? Answer: No. This would constitute double billing of the extremity angiograms. As shown below, code 75630 includes an aortogram and visualization and interpretation of bilateral lower extremity arteries via a run-of. For this code, a...

Iliac Artery Aneurysm Treatment Coding
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Iliac Artery Aneurysm Treatment Coding

November 11, 2021 Question: How do I code for an isolated iliac artery treated endovascularly with an iliac endograft? Answer: These codes were revised in 2018 to include either ruptured or unruptured iliac aneurysms. In addition, non-selective catheterization and radiological supervision and interpretation are now inclusive. The full code descriptions are shown below. The CPT...

Use of a Scribe
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Use of a Scribe

October 28, 2021 Question: We are hiring a scribe for the doctor because it will help improve his documentation. Is there anything we need to know about how to document this? Answer: Yes, absolutely. This situation should be clearly delineated so a third party reviewer can identify the provider who performed the service, and the...

How Do You Define “No Qualified Resident Available”?
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How Do You Define “No Qualified Resident Available”?

October 14, 2021 Question: Our physicians utilize residents during surgery but we have a discrepancy in what is considered a “Qualified Resident”. Some physicians consider a resident qualified to assist day 1 of their residency rotation, while others consider only 4th and 5th year residents as qualified to assist. Can you guide us to documentation...

Coding for In-Stent Carotid Stenosis
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Coding for In-Stent Carotid Stenosis

September 30, 2021 Question: How is angioplasty of a previously placed carotid stent that is now occluded billed? Answer: For a patient treated with angioplasty for with occlusion in a previously placed carotid stent, report code 37246, Transluminal balloon angioplasty, (except lower extremity artery(ies) for occlusive disease, intracranial, coronary, pulmonary, or dialysis circuit) open or...

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

September 16, 2021 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 or 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...

Coding TCAR
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Coding TCAR

September 2, 2021 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...

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

August 5, 2021 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?

July 22, 2021 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 are...

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