suela923@aol.com
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Doctor attempted to do an intervention but was unable to complete, can I bill the procedure code with the modifier 74? Dr Z's book states that this can be used after the induction of anesthia OR AFTER THE PROCEDURE HAS BEEN STARTED (e.g. incision made, catheter inserted, biopsy pass attempted).
If the modified procedure isn't billable would it be appropriate to bill for the equipment only? My trainer seems to remember that she was told there must be a procedure billed.
Procedure: Right leg angiogram and attempt at treating a chronic total occlusion.
Indication: Nonhealing ulceration in right foot.
Results: Patient was identified and brought to the vascular unit. The left groin was prepped and draped in usual sterile fashion. 2% lidocaine was used to infiltrate the skin over the left femoral artery. An angiographic needle, wire, and 6-French sheath were then placed. A selective catheter was utilized to negotiate the aortic bifurcation and the sheath was placed up and over the aortic bifurcation with its tip in the right femoral artery. The patient was heparinized with 6000 units of heparin. Note this was an intervention only as a prior diagnostic study was performed. Roadmapping was performed to identify the chronic total occlusion in the distal superficial femoral artery. Attempts to cross this lesion with various catheters, wires, and frontrunner device were not successful. At the completion of the case the sheath was removed and the left groin was sealed with an Exoseal closure device. Patient tolerated the procedure well and left in stable condition. Completion studies showed continued persistence of the chronic total occlusion in the distal SFA.
Thanks!!
Sue
If the modified procedure isn't billable would it be appropriate to bill for the equipment only? My trainer seems to remember that she was told there must be a procedure billed.
Procedure: Right leg angiogram and attempt at treating a chronic total occlusion.
Indication: Nonhealing ulceration in right foot.
Results: Patient was identified and brought to the vascular unit. The left groin was prepped and draped in usual sterile fashion. 2% lidocaine was used to infiltrate the skin over the left femoral artery. An angiographic needle, wire, and 6-French sheath were then placed. A selective catheter was utilized to negotiate the aortic bifurcation and the sheath was placed up and over the aortic bifurcation with its tip in the right femoral artery. The patient was heparinized with 6000 units of heparin. Note this was an intervention only as a prior diagnostic study was performed. Roadmapping was performed to identify the chronic total occlusion in the distal superficial femoral artery. Attempts to cross this lesion with various catheters, wires, and frontrunner device were not successful. At the completion of the case the sheath was removed and the left groin was sealed with an Exoseal closure device. Patient tolerated the procedure well and left in stable condition. Completion studies showed continued persistence of the chronic total occlusion in the distal SFA.
Thanks!!
Sue