Help with Coding - An 82-year-old male has a history of carotid stenosis

[MrsAllen07]

An 82-year-old male has a history of carotid stenosis. The patient underwent a left carotid endarterectomy a few weeks ago and now presents with critical stenosis of his right internal carotid artery. A standard endarterectomy was performed on a single vessel. Debris was removed from the artery and the artery was irrigated with heparinized saline.

Double Checking

Dx- 433.10

Px-38.12, 00.40, 35500

 

[mitchellde]

Is this for an exam? Homework? Are you coding inpatient facility or physician? I ask because you would never code vol3 codes and CPT codes together.

 

[MrsAllen07]

It's for homework, so 35500 would go by it self. I'm just a little confused

 

[MrsAllen07]

I found the the code for irrigated with heparinized saline 96523x1

 

[mitchellde]

The correct codes depend on whether this is for facility or physician billing, inpatient facility never uses CPT codes or HCPC II codes, and physician will never use vol 3 codes.

 

[MrsAllen07]

It's for inpatient so your saying I would not use 96523 for inpatient facility coding

 

[mitchellde]

That is correct. Inpatient is paid a DRG based on the dx code, certain procedure codes from Vol 3 will alter the DRG assignment. I am surprised this has not been covered in your classes.

 

[MrsAllen07]

Im going to be switching over to start taking my classes on AAPC Im going to try for the CIC

 

[mitchellde]

Inpatient is very different from physician. You have to think in a whole different way sometimes. Good luck in all you do!