Wiki ?Code...intra-op RICA angiography....

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margaret fahy

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08/26/13
Hi, Guys..
Can someone tell me which code to use for the following intra-op rica angiography thru existing sheath..catheter placement thru existing sheath....
Is it just Fluoro guidance, as there is no associated RS&I code for 36224?
Thanks, Margie

Indications:
Diagnosis:AVM (arteriovenous malformation) brain [747.81 (ICD-9-CM)]
Reason:Intraoperative for AVM.



Interpretation: Intraoperative right internal carotid angiography

Clinical history: Resection of right cerebral AVM. Patient in
the operating room with open craniotomy


Procedure: Using the pre-existing 4 French right femoral artery
sheath, the site was prepped, and a 4 French Berenstein catheter
was placed into the right internal carotid artery with the aid
of a 0.035 inch diameter and Newton guidewire and intraoperative
fluoroscopy. AP and lateral angiography was performed. No
complications were appreciated. The images were reviewed with
Dr. The catheter was then removed, leaving the sheath in
place until the craniotomy closure occurred.

Findings: As expected, the imaging is degraded by the presence
of the stabilizing head frame and overlying operative materials.
Right internal carotid angiography in the frontal and lateral
projections reveals no evidence of residual AVM nidus, no early
draining vein, and no unexpected arterial occlusions.

IMPRESSION
Satisfactory intraoperative appearance following
right cerebral AVM resection, prior to craniotomy closure
 
margaret fahy said:
08/26/13
Hi, Guys..
Can someone tell me which code to use for the following intra-op rica angiography thru existing sheath..catheter placement thru existing sheath....
Is it just Fluoro guidance, as there is no associated RS&I code for 36224?
Thanks, Margie

Indications:
Diagnosis:AVM (arteriovenous malformation) brain [747.81 (ICD-9-CM)]
Reason:Intraoperative for AVM.



Interpretation: Intraoperative right internal carotid angiography

Clinical history: Resection of right cerebral AVM. Patient in
the operating room with open craniotomy


Procedure: Using the pre-existing 4 French right femoral artery
sheath, the site was prepped, and a 4 French Berenstein catheter
was placed into the right internal carotid artery with the aid
of a 0.035 inch diameter and Newton guidewire and intraoperative
fluoroscopy. AP and lateral angiography was performed. No
complications were appreciated. The images were reviewed with
Dr. The catheter was then removed, leaving the sheath in
place until the craniotomy closure occurred.

Findings: As expected, the imaging is degraded by the presence
of the stabilizing head frame and overlying operative materials.
Right internal carotid angiography in the frontal and lateral
projections reveals no evidence of residual AVM nidus, no early
draining vein, and no unexpected arterial occlusions.

IMPRESSION
Satisfactory intraoperative appearance following
right cerebral AVM resection, prior to craniotomy closure
Click to expand...

This report contains all of the components of 36224. Whether or not to bill for this depends on the code for the craniotomy, does it include (bundle) 36224?

HTH
 
Intra-op rica

Danny,
I thought that because they went thru the existing sheath and dr. did not pass needle thru skin that I couldn't bill for the 362224.
Is it okay to bill this if the access was already there?
Margie
 
margaret fahy said:
Danny,
I thought that because they went thru the existing sheath and dr. did not pass needle thru skin that I couldn't bill for the 362224.
Is it okay to bill this if the access was already there?
Margie
Click to expand...

Yes, as long as it isn't bundled into the primary procedure code.
 
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