Radiology Coding Alert

Ignoring serialography codes? You could be losing deserved dollars   Component coding for individual interventional procedure elements increases your risk of missing a code for your claim -- and reimbursement for your practice. Take control with this expert advice on nonselective procedures.   Tackle Tough Arterial Claims With These CPT Skills   You should consider either of the following to be nonselective arterial catheter placement, says Stacy Gregory, RCC, CPC, of Tacoma, Wash.-based Gregory Medical Consulting Services, in her audioconference for The Coding Institute, “Success Strategies for Interventional Radiology Vascular Coding” (get your own CD at www.audioeducator.com): the radiologist places the catheter or needle directly into an artery and does not manipulate or move it into a branch the radiologist moves the catheter or needle into the aorta from any approach with no further manipulation.   Remember: You should code each vascular access separately, Gregory says. The codes you’ll use for nonselective arterial catheterization include the following, Gregory says: 36100 -- Introduction of needle or intracatheter, carotid or vertebral artery 36120 -- Introduction of needle or intracatheter; retrograde brachial artery 36140 -- ... extremity artery 36145 -- ... arteriovenous shunt created for dialysis (cannula, fistula or graft) 36160 -- Introduction of needle or intracatheter, aortic, translumbar 36200 -- Introduction of catheter, aorta.   Example 1: The radiologist performs a nonselective arch aortogram to evaluate the great vessels. If he performs and documents a femoral or axillary approach, with the catheter in the ascending aorta, you should report 36200 and 75650 (Angiography, cervicocerebral, catheter, including vessel origin, radiological supervision and interpretation), Gregory says. Example 2: The radiologist performs an abdominal aortogram (from a femoral or brachial approach), placing the catheter in the upper abdominal aorta. You should report 36200 and 75625 (Aortography, abdominal, by serialography, radiological supervision and interpretation), Gregory says. Common mistake: Don’t let the term “serialography” confuse you and convince you not to use 75625 when appropriate. “Serialography is the technique of taking radiographic images in rapid sequence for the study of high-speed phenomena (such as the flow of blood through an artery). This is more commonly referred to as multiple rapid sequence imaging,” Gregory says.   Discover How Options Change With Vena Cava   Nonselective venous catheter placement involves either of the following, Gregory says: the radiologist places the catheter or needle directly into a peripheral vein and does not manipulate or move the catheter or needle further into a branch the radiologist moves the catheter or needle into the vena cava (inferior or superior) from any approach with no further manipulation.   The codes you’ll use for nonselective venous catheterization include the following, Gregory says: 36000 -- Introduction of needle or intracatheter, vein 36005 -- Injection procedure [...]