Advanced Search

Cardiology Coding Alert

Reader Question:

Brachytherapy

Published on Thu Mar 01, 2001

Question: Our cardiologists would like to use brachytherapy in association with heart catheters to try to prevent restenosis of stents. Will Medicare pay for this procedure? How should it be coded?

California Subscriber

Answer: Coronary brachytherapy is intended to treat in-stent restenosis, which causes coronary stents to become clogged with new tissue growth or with scar tissue that has formed after stent placement, says Diane Elvidge, CPC, senior reimbursement specialist with Princeton Reimbursement Group in Minneapolis.

The procedure should be billed with 93799 (unlisted cardiovascular service or procedure) and the same diagnosis code used for the primary intervention. Unfortunately, most local Medicare carriers dont cover this relatively new service. For example, the local medical review policy for Empire Medicare Services, the local Medicare carrier for New Jersey and 16 counties in southeastern New York state, specifies, A claim for coronary brachytherapy for restenosis will be denied as investigational.
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Cardiology Coding Alert

View All