Neuroendovascular Coding

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Question:

We just hired a neuroendovascular surgeon and his cases are complicated to code! He says he did a “three vessel angiogram” so does that mean I will report 3 codes (36217 x 3)?

Answer:

Good question and, yes, the coding for these cases is complex! Rather than documenting a “three vessel angiogram” we recommend the physician document the specific vessels catheterized.That level of specificity is necessary in order to choose the correct codes. You’ll report one stand-alone code (36215 or 36216 or 36217) for the highest order of vessel catheterized in each separate vascular family. Then you will report an add-one code (36218) for additional vessels separately catheterized in each vascular family. Don’t forget that you can also report the associated radiological supervision and interpretation (S&I) codes, with modifier 26, if there is documentation of the surgeon’s radiologic interpretation.

The bottom line is that you need to know the head and neck as well as spinal vascular anatomy and how the catheterization and radiology codes relate. A great resource is KZA’s GPS for Neuroendovascular Coding!