Category: CC-Vascular

Catheterization and Intervention Billing
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Catheterization and Intervention Billing

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...

Nonselective or Selective
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Nonselective or Selective

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.

Modifier 52 vs. 53
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Modifier 52 vs. 53

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...

New 2021 E/M Coding Guidelines
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New 2021 E/M Coding Guidelines

December 17, 2020 Question: In the new guidelines, how does Time affect billing for a teaching physician’s E/M service when the resident spends a great deal of time with the patient? Answer: Good question! Only the time of teaching physician would “count” in the scenario you describe. The new guidelines say that the time of...

Stent vs. Embolization or Both
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Stent vs. Embolization or Both

December 3, 2020 Question: If the surgeon uses a covered stent and performs an embolization on a patient with a pseudoaneurysm, can we bill for both the stent and removal of the embolus? Answer: If a covered stent is deployed as the sole management of an aneurysm, pseudoaneurysm or vascular extravasation, then the stent deployment...

Dialysis Circuit Revision
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Dialysis Circuit Revision

October 29, 2020 Question: My vascular surgeon performed a dialysis circuit open revision, and had to remove subcutaneous fat during the procedure. He said this was a more complex procedure than usual, so is there another code to use besides 36832? Answer: Removing excess subcutaneous fat is included in the work for 36832, so this...

Billing Separately for Diagnostic Angiograms
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Billing Separately for Diagnostic Angiograms

October 15, 2020 Question: Our surgeon performed an aortogram with run-off to bilateral lower extremities. He then performed interventions in the left SFA and the left peroneal arteries. My question is regarding documentation of the diagnostic imaging Can he also bill for a diagnostic angiogram? What about catheterization to get there? Answer: Diagnostic imaging during...

Confusion About New 2021 E/M Guidelines
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Confusion About New 2021 E/M Guidelines

October 1, 2020 Question: The new guidelines that are coming out in 2021 for all types of E/M services, right? Answer: No. The new guidelines are for office/outpatient visit codes only (99202-99215). You will still need to use the current guidelines for all other E/M services, even consultations in the office. *This response is based...

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Coding Coaches