# I need your help coding this one,



## lblanchette (Jun 2, 2009)

Procedure: Wthe patient supine, the right groin was prepared and draped in the usual sterile fashion. Using micropuncture technique, the right common femoral artery was accessed and a 5 Fr sheath was placed. Through this sheath a 5 Fr Simmons II selective catheter was directed into the left and right common carotid arteries and the left vertebral artery where selective injections of the contrast material were made and digital subtraction images of the cervical and cerebral circulations were obtained. Catheters and guidewires were then removed and hemostasis was achiever by use of manual compression. The patien tolerated the procedure well without complication. 

They billed 36215-(51,59), 36216 & 36216 (51)- Would this be appropriate?

Thanks


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## jtuominen (Jun 2, 2009)

As long as the patient has normal arch anatomy (with no deviations like Bovine Arch, etc)
I would code:

Cath Placements:
R CCA -- 36216-59
L CCA -- 36215
L Vert -- 36215

RS&I
RCCA and LCCA -- 75671 (cerebral), 75680 (cervical)
LVert -- 75685

You should probably find out if the patient has normal arch anatomy, because if they don't that codeset you list is quite probable. As far as that -51 modifier I am unsure since I am a facility side coder. I bet someone else will chime in here. Good luck!


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## deeva456 (Jun 2, 2009)

Hello,

We dont do too many cerebral/cervical interventions but looking at the cath  placement I would add modifier 59 to the L Vert to indicate it is separate vessel. Wouldnt you need RT & LT modifiers to support or indicate that the cath placement was done on both the left and right side? 

R CCA -- 36216- RT
L CCA -- 36215- LT
L Vert -- 36215- 59

RS&I
RCCA and LCCA -- 75671 (cerebral), 75680 (cervical)
LVert -- 75685

I agree with the imaging codes, but you need to add modifier 26 to these codes.


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## Shirleybala (Jun 3, 2009)

The codes are:

R CCA -- 36216
L CCA -- 36215-5951
L Vert -- 36216-5951(LT vertebral is a second order)

RS&I
RCCA and LCCA -- 75671-26 (cerebral), 75680-26 (cervical)
LVert -- 75685-26


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## lblanchette (Jun 4, 2009)

Thanks everyone...


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