June 10, 2021 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...
May 27, 2021 Question: What does “separate procedure” mean when it follows a CPT code description? Answer: Per CPT : Some of the procedures or services listed in the CPT codebook that are commonly carried out as an integral component of a total service or procedure have been identified by the inclusion of the term...
May 13, 2021 Question: A vascular surgeon is requested to come to the OR to repair a blood vessel that my surgeon inadvertently nicked during a colectomy. Is he a co-surgeon or assistant on the case? Answer: Neither. The vascular surgeon will report his work, repair of vessel, and you will report yours. *This response...
April 29, 2021 Question: How is a left femoral to right femoral artery bypass with PTFE reported? Answer: Report code 35661, Bypass graft, with other than vein, femoral- femoral. This code applies to fem-fem bypass in the same leg or from one leg to the opposite leg. *This response is based on the best information...
April 15, 2021 Question: I was told catheterization is included in the embolization codes, 37241-37244. Is that correct? Answer: No, per CPT catheterization is separately reported with all the embolization codes, 37241- 37244. *This response is based on the best information available as of 04/15/21.
April 1, 2021 Question: Our vascular surgeon did a single intervention on a lesion that was at the juncture of the femoral/popliteal and tibial/peritoneal territories. Can we charge for two interventions? Answer: Lesions that extend across the margins of one vessel vascular territory into another, but can be treated with a single therapy are reported...
March 18, 2021 Question: During a catheterization the surgeon performed a venogram. I don’t see that these procedures are bundled, is that correct? Answer: Venous catheterization codes are separately reported with venograms, unless they are performed at the same session with an intervention that includes catheterization. *This response is based on the best information available...
March 4, 2021 Question: Does TEVAR allow for billing of catheterization and intervention? Would a 59 modifier be needed? Answer: Yes, billing for a catheterization in addition to the TEVAR is allowed. And no, a modifier 59 is not needed as these two codes do not bundle. *This response is based on the best information...
February 18, 2021 Question: When does a nonselective catheterization become a selective catheterization? Answer: If the catheter (not just the wire) is manipulated into another vessel beyond the puncture site or beyond the aorta, then it is coded as a selective catheterization. *This response is based on the best information available as of 02/18/21.
February 4, 2021 Question: We are confused about the difference between modifier 52 and 53. What is the difference? Answer: Modifier 52 Reduced Services is used when the procedure or surgery is partially reduced or eliminated by the physician. This is used when a procedure has an existing CPT code, but not all of the...
