November 14, 2019 Question: The physician staged a patient’s bilateral carotid stent with embolic protection procedures. The right carotid stent was done first and then the 6 weeks later the left side was done. What is the correct modifier on the second carotid stent? Answer: The second carotid stent, although staged clinically, is an unrelated...
October 31, 2019 Question: Our vascular surgeon provided exposure for a neurosurgeon for a 3 level anterior spine procedure. We were told to bill 22558 only. Is that correct? Answer: No. If exposure for three levels is performed, the vascular surgeon may report 22558 Arthrodesis, anterior interbody technique for the first level, and the...
October 17, 2019 Question: A neurosurgeon asked my vascular surgeon to perform the exposure for an anterior spine procedure. Does he report an exploratory lap his work? Answer: No. providing the exposure for a neurosurgeon for an anterior spine procedure is co-surgery, since code 22558, Arthrodesis, anterior interbody technique includes both the exposure/approach and the...
October 3, 2019 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...
September 19, 2019 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...
September 5, 2019 Question: I’ve been dictating CPT and ICD-10-CM codes in my procedure note so that my coder knows what to bill. Recently, we had an insurance company call us out because the codes we billed were not the same as the codes in the procedure note. Now I am not sure what to...
August 22, 2019 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...
August 8, 2019 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...
July 25, 2019 Question: How is angioplasty of a previously place carotid stent 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 percutaneous, including all imaging...
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...
