Category: Vascular

Lesion Crossing Two Territories
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Lesion Crossing Two Territories

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...

Venogram and Catheterization
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Venogram and Catheterization

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...

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...

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