Wiki G0275 & g0278

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decus1956

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Procedure: Left Heart cath was done.....Then a pigtail cath was placed in proximal AA and abdominal aortography was performed. Cath was removed. In view of findings and patients documented ischemia in RCA, percutaneious revascularization of RCA was undertaken. A french AR-1 guide was advanced through sheath over wire to AA. After confirmation of central arteril pressure, this was place in ostium of RCA. Cougar wire advanced into RCA, past level of stenosis to distal vessel. A balloon was advanced into are of narrowing w/in previous placed stent and inflated. The balloon was withdrawn in guiding cath and repeat angiography was performed. Balloon was exchanged for Xience stent which was deployed w/in previous stent. The balloon was withdrawn slightly and used to redilate this area, as well as ostium. Balloon was withdrawn in the guiding cath and repeat angio was performed. Balloon and guide wire were removed. Repeat angio was performed. Guiding caht was removed. Arterial sheath was sewn in place. Under the doctors Abdominal Aortography notes: He states AA demonstrates midl intraluminal narrowing of mid and distal AA. There is narrowing in proximal portion of R. renal artery. Also narrowing in proximal portion of L renal artery. The left common iliac artery demonstrates diffuse irregularity w/max stenosis 20% just prior to bifurcatin. Mild diffuse irregularity seen in R. CIA, as well.

I coded: 93458.26.59, 92928 RC, 75625.26.59

Mcare denied the 75625.26.59.....My question should the code be G0278 since AA was done with heart cath or do I just have modifiers wrong on 75625 or should it be 75625 and 75716 with mod 26?


Also, can someone clarify to me when to use G0275 & G0278 codes? I am confused on when. I was told to use them when Abdominal Aorta is done with heart caths....

Thanks fellow coders for all your help!
 
deannegreen said:
Procedure: Left Heart cath was done.....Then a pigtail cath was placed in proximal AA and abdominal aortography was performed. Cath was removed. In view of findings and patients documented ischemia in RCA, percutaneious revascularization of RCA was undertaken. A french AR-1 guide was advanced through sheath over wire to AA. After confirmation of central arteril pressure, this was place in ostium of RCA. Cougar wire advanced into RCA, past level of stenosis to distal vessel. A balloon was advanced into are of narrowing w/in previous placed stent and inflated. The balloon was withdrawn in guiding cath and repeat angiography was performed. Balloon was exchanged for Xience stent which was deployed w/in previous stent. The balloon was withdrawn slightly and used to redilate this area, as well as ostium. Balloon was withdrawn in the guiding cath and repeat angio was performed. Balloon and guide wire were removed. Repeat angio was performed. Guiding caht was removed. Arterial sheath was sewn in place. Under the doctors Abdominal Aortography notes: He states AA demonstrates midl intraluminal narrowing of mid and distal AA. There is narrowing in proximal portion of R. renal artery. Also narrowing in proximal portion of L renal artery. The left common iliac artery demonstrates diffuse irregularity w/max stenosis 20% just prior to bifurcatin. Mild diffuse irregularity seen in R. CIA, as well.

I coded: 93458.26.59, 92928 RC, 75625.26.59

Mcare denied the 75625.26.59.....My question should the code be G0278 since AA was done with heart cath or do I just have modifiers wrong on 75625 or should it be 75625 and 75716 with mod 26?


Also, can someone clarify to me when to use G0275 & G0278 codes? I am confused on when. I was told to use them when Abdominal Aorta is done with heart caths....

Thanks fellow coders for all your help!
Click to expand...

If the patient's primary insurance is Medicare, then you use the g-codes (also C-codes for coronary drug eluting stents for hospital charging). Otherwise use the CPT code.
 
Thanks, Jim

I thought so, but wasnt for sure. I really appreciate you getting back on this with me.
 
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