Wiki Cabg

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vergor

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Hello,

I need a little help. When coding a CABG within the groups of 33533-33536 my physicians also do an endoscopic (33508). The problem being within the rules those codes are not billed with that code (33508).

I have explained to the physician this but they keep billing it. I am starting to question myself am I correct on this. It is within their notes that the endoscopic is performed during that surgery.

Can anyone give me some advise on this matter? it would be greatly appreciated.
 
vergor said:
Hello,

I need a little help. When coding a CABG within the groups of 33533-33536 my physicians also do an endoscopic (33508). The problem being within the rules those codes are not billed with that code (33508).

I have explained to the physician this but they keep billing it. I am starting to question myself am I correct on this. It is within their notes that the endoscopic is performed during that surgery.

Can anyone give me some advise on this matter? it would be greatly appreciated.
Click to expand...


We are billing the 33508 for endoscopic vein harvesting. It is a payable and appropriate code. We learned this recently when one of our Coders went to the Cardiothoracic coding conference in November. I hope this helps :)
 
vergor said:
Hello,

I need a little help. When coding a CABG within the groups of 33533-33536 my physicians also do an endoscopic (33508). The problem being within the rules those codes are not billed with that code (33508).

I have explained to the physician this but they keep billing it. I am starting to question myself am I correct on this. It is within their notes that the endoscopic is performed during that surgery.

Can anyone give me some advise on this matter? it would be greatly appreciated.
Click to expand...

33508 is an add-on code and the book says to use it with 33510-33523, but we too sometimes need to bill it with with 33533-33536. Sometimes the surgeon will take the vein endoscopicially to find that it is too small, not good quality, etc... then they opt to use only arterial grafts. Sometimes this is done by using the LIMA, RIMA or both. If they harvested the radial artery for use as one of the arterial grafts don't forget to code for that too (add-on code 35600). Send op-report if 33508 is denied.
 
Cabg 33508

You would never bill for 33508 if the vein is not used. Please see below from 2014 STS conference:

? Patient with previous aortic valve replacement presents with severe coronary artery
disease. Chest is reopened, coronary artery bypass grafting x 3 with LIMA to LAD,
RIMA to RCA and radial artery to diagonal. Endoscopic vein harvested, not suitable for
grafting so was not used. Endarterectomy of diagonal. What codes should be
reported?

Correct answer:

33535
33572
35600
33530

Did not use any venous conduit, so even though indicates
EVH (33508) was harvested and not used, no charge
because no vein used, no associated primary code reported
(has to be reported with venous CABG procedure)
 
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