Wiki 75898 for follow up angiography

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jtuominen

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I wanted to know what the general consensus is on this situation... as I have run into several coders who have differing opinions on this...

If a cerebral embolization is performed (61624, 75894) with lets say 4 coils in the basilar artery, and MD dictates that he did 4 angios prior to the deployment of each of those coils, plus one final diagnostic angiogram to confirm total occlusion of the angiogram, would you give them credit for the final diagnositc angiogram?

So the question is how many 75898's would you give them? 4 or 5?
 
If he only did ONE follow-up angiogram POST embolization, I would only bill for one 75898.
 
Ok, I see the prior/post issue. How about
4 coils placed, an angio post deployment of each
Followed up by one more final angiogram at the end to confirm total occlusion of the aneurysm.

We are having a back and forth about these final angiograms. Some want to charge for it, so there would be a total of 5 follow up angiograms (75898). Some only want to charge 4.

Thanks for the help!!!! so so much!
 
If the coiling is all being done in the same artery (which it sounds like it is), there would only be one follow-up. The # of coils placed doesn't determine the # of follow-ups.
 
really? Even for an intracranial embolization? I thought for sure you could bill for those follow ups more than once? Thanks for the thoughts. I appreicate it!
 
For intracranial or spinal cord procedures, use 75898 per follow-up angiogram performed with embolization or infusion therapy services.

If there were multiple sites/arteries embolized I would use the 75898 for each site/artery that was embo'd. (for intracranial embo's) not for each "coil" that was placed.

does that make sense?
 
When docuemnted, follow-up angiography is separatley coded.For non-neurologic embolizations, 75898 should only be rpeorted once per encounter per operative site. For neuroembolozations(intracranial or spinal cord) more than one 75898 may be reported. This is from the CSI coding guidelines
 
I decided to send the question off to our coding consulting company. Hopefully that will clear it up. Thanks for the help everyone!
 
jtuominen said:
I decided to send the question off to our coding consulting company. Hopefully that will clear it up. Thanks for the help everyone!
Click to expand...

I went to a coding conference sponsored by Medlearn, and the presenter stated that you can use the 75898 for each post embolization imaging on the GDC coil, as long as it is documented.

Jim Pawloski,CIRCC, R.T.(CV)
NHR
 
reports that I have seen, the phys. may deposit numerous coils and afterwards to a follow-up (75898), I can't say that i've ever seen them document a follow-up after each individual coil that was placed. I've seen over 20+ coils placed in one artery...so they're saying it's ok to bill for 20+ follow-ups?
 
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