Wiki Cerebral AVM Embolization

[Jim Pawloski]

I have a patient who had a four vessel cerebral arteriogram, an embolization with Onyx embolization material, and then a repeat four vessel arteriogram. The Neuro Interventional Radiologist wants me to bill for the second four vessel arteriogram because he wanted to see if any other vessels would feed the AVM. I say no, it part of the post embolization code. Any opinions?

Thanks,
Jim Pawloski, R.T.(CV), CIRCC

 

[margaret fahy]

Hi, JIm,
Do you mean the 75898 post embo angio code?
If so,you can bill for more than one 75898 for the 61624 procedures.

"For neuroembolization procedures, more than one unit of 75898 can be reported if more than one follow-up angiogram is documented."

Or maybe that's not what you mean....
Margie

 

[dpeoples]

I have a patient who had a four vessel cerebral arteriogram, an embolization with Onyx embolization material, and then a repeat four vessel arteriogram. The Neuro Interventional Radiologist wants me to bill for the second four vessel arteriogram because he wanted to see if any other vessels would feed the AVM. I say no, it part of the post embolization code. Any opinions?

Thanks,
Jim Pawloski, R.T.(CV), CIRCC

Jim,
I agree with you (and Margie), this is really the post embolization follow up, that is the very purpopse of the code. If the physician is checking 4 different "embolized' sites, then you can code 75898 X4 (as an example).


HTH

 

[Jim Pawloski]

Jim,
I agree with you (and Margie), this is really the post embolization follow up, that is the very purpopse of the code. If the physician is checking 4 different "embolized' sites, then you can code 75898 X4 (as an example).


HTH

It's one site for the AVM. The doctor removed the microcatheter, and performed a full bilateral internal carotid, and bilateral vertebral to see if any more arteries had opened post Onyx treatment. I can see the treated side, but all four? That's where I have the trouble.

 

[dpeoples]

It's one site for the AVM. The doctor removed the microcatheter, and performed a full bilateral internal carotid, and bilateral vertebral to see if any more arteries had opened post Onyx treatment. I can see the treated side, but all four? That's where I have the trouble.

If the phsician had already performed the diagnostic work (in this session), repeating those procedures is just continuing the diagnostic work already coded, not a true repeat. For instance, 36224 is not just a single injection and images, it is as many injections and images needed to identify disease process or other abnormalities in the carotid distribution, in the same session.

HTH

 

[Jim Pawloski]

If the phsician had already performed the diagnostic work (in this session), repeating those procedures is just continuing the diagnostic work already coded, not a true repeat. For instance, 36224 is not just a single injection and images, it is as many injections and images needed to identify disease process or other abnormalities in the carotid distribution, in the same session.

HTH

Thanks for you opinion Danny. I just wanted to make sure that I was not missing anything.

Jim