Wiki Open Thrombectomy--2 times one session

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Robbin109

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Pt has a open thrombectomy of Popliteal, AT and PT. Pretty normal procedure. Surgery complete and patient is closed.

Before they leave the room, it is noticed the signal is completely gone.
Pt had to be reintubated, re-prepped, re-opened and the same procedure repeated. Again Thrombectomy of POP, AT and PT.

Can this second procedure be coded?
 
Unfortunately no, the second procedure cannot be reported separately. CPT 34203 for the open thrombectomy of these vessels has an MUE of 1 per CMS with an MAI indicator of "2: Date of service." This is a binding edit (meaning coding in excess of the MUE is considered to be a coding error based on correct coding principles or CMS policy). I think the reason for the edit is that it is often necessary to make multiple passes with a catheter down the vessel to completely remove thrombus, and they are indicating that all efforts to completely declot the vessels would be reported with just one unit of the code. So in this case, I would stick with coding the 34203 just once. You might consider adding a modifier 22 if the surgeon documented the additional time/effort to warrant that increased complexity modifier since they had to re-prep and re-open which is certainly more difficult than just making another pass with the catheter while the surgical field is still open. I hope that helps :)

Kim
www.codingmastery.com
 
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