EstherImmanuel
Contributor
Can someone please help explain this to me?
Via a right femoral puncture, a guiding sheath is advanced into the right internal carotid artery & carotid cerebral imaging are obtained,which shows anterior cerebral artery aneurysm(36224) .Then it was decided to place the coil for aneurysm embolization. Embolization (61624 Transcatheter permanent occlusion or embolization (eg, for tumor destruction, to achieve hemostasis, to occlude a vascular malformation), percutaneous, any method; central nervous system (intracranial, spinal cord)and 75894 Transcatheter therapy, embolization, any method, radiological supervision and interpretation). Completion angiography demonstrates flow diversion and successful procedure with patency of the native vessel & then there is found to be thrombus in middle cerebral artery(75898) ,hence it was initiated thrombolyis infusion therapy. (37211)
Here in this scenario,embolization coil is placed in anterior cerebral artery & thrombolysis infusion catheter is placed in middle cerebral artery,so anterior cerebral & middle cerebral arteries are the branches of internal carotid artery which is only selectively catherized & imaged but not its branches,but the interventions are done in the branches so that would be the highest order.
Thus can we need to code 36224 along with 36217(only selective catherization code) or 36224,36228,36228-59(here it is not imaged to code 36228) or it is enough to bill 36224 alone only once with the interventions 61624,75894,75898 & 37211.Please anyone clarify me as it is really confused to code such scenarios.
Thanks,
Esther Immanuel
Via a right femoral puncture, a guiding sheath is advanced into the right internal carotid artery & carotid cerebral imaging are obtained,which shows anterior cerebral artery aneurysm(36224) .Then it was decided to place the coil for aneurysm embolization. Embolization (61624 Transcatheter permanent occlusion or embolization (eg, for tumor destruction, to achieve hemostasis, to occlude a vascular malformation), percutaneous, any method; central nervous system (intracranial, spinal cord)and 75894 Transcatheter therapy, embolization, any method, radiological supervision and interpretation). Completion angiography demonstrates flow diversion and successful procedure with patency of the native vessel & then there is found to be thrombus in middle cerebral artery(75898) ,hence it was initiated thrombolyis infusion therapy. (37211)
Here in this scenario,embolization coil is placed in anterior cerebral artery & thrombolysis infusion catheter is placed in middle cerebral artery,so anterior cerebral & middle cerebral arteries are the branches of internal carotid artery which is only selectively catherized & imaged but not its branches,but the interventions are done in the branches so that would be the highest order.
Thus can we need to code 36224 along with 36217(only selective catherization code) or 36224,36228,36228-59(here it is not imaged to code 36228) or it is enough to bill 36224 alone only once with the interventions 61624,75894,75898 & 37211.Please anyone clarify me as it is really confused to code such scenarios.
Thanks,
Esther Immanuel
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