Wiki 36247 Unbundled

[sorcha48]

I am not a IR coder by vocation. I am auditing claims for services provided.

I am looking at a bill that has 36247 with 36245-59.

I looked online and it appears 36245 can not be there when 36247 is.

The procedure was an Transarterial chemoembolization of left hepatic lobe tumor. Here is what I have in the surgery notes.

The findings indicated: The left hepatic artery branch vessel selected.
Impression: Successful transarterial chemoemoblization from second order branch of a replaced left hepatic artery.

Before I send back the claim, can anyone tell me whether 36245-59 should be on the claim?

 

[mk2001]

I am not a IR coder by vocation. I am auditing claims for services provided.

I am looking at a bill that has 36247 with 36245-59.

I looked online and it appears 36245 can not be there when 36247 is.

The procedure was an Transarterial chemoembolization of left hepatic lobe tumor. Here is what I have in the surgery notes.

The findings indicated: The left hepatic artery branch vessel selected.
Impression: Successful transarterial chemoemoblization from second order branch of a replaced left hepatic artery.

Before I send back the claim, can anyone tell me whether 36245-59 should be on the claim?

If that was the only catheter placement I only see that 36247 should be billed.

 

[sorcha48]

If that was the only catheter placement I only see that 36247 should be billed.

Would you consider billing 36245 as unbundling if it was the only catheter?

 

[khemchand]

I am not a IR coder by vocation. I am auditing claims for services provided.

I am looking at a bill that has 36247 with 36245-59.

I looked online and it appears 36245 can not be there when 36247 is.

The procedure was an Transarterial chemoembolization of left hepatic lobe tumor. Here is what I have in the surgery notes.

The findings indicated: The left hepatic artery branch vessel selected.
Impression: Successful transarterial chemoemoblization from second order branch of a replaced left hepatic artery.

Before I send back the claim, can anyone tell me whether 36245-59 should be on the claim?

correct catheterization code for this documentation is only CPT 36247

 

[Jim Pawloski]

The only way you could have a 36245-59 is if a different vascular family was selected, i.e SMA or IMA was selected. As to what you have posted, you can only code 36247.