Wiki This is a tricky one..can you help?

Create Wiki
C

com107

Contributor
Messages
20
Location
Pittsgrove, NJ
Best answers
0
My doctor did:
1. Endovascular repair of infrarenal abdominal aortic aneurysm using Medtronic Endurant stent graft with the main body measuring 23 x 13 x 124, contra lateral limb on the left side measuring 16 x 10 x 93 and ipsilateral limb iliac intension on the right side measuring 16 x 10 x 82
2. Bilateral renal artery angiogram via selective catheterization of bilateral renal arteries.
3. Bilateral renal artery angioplasty and stenting with right side Express LD 5 x 17mm stent and left side Express LD 6 x 27mm stent.
4. Completion aortograms
5. Bilateral femoral artery cutdowns.

These are the codes I came up with:
34812-50, cutdowns
34802, prosthesis w/1 docking limb
34825, extension
35471-50, angioplasty
37205, stent
37206, addition stent
75952-26 radiology
75953-26 radiology

What do you thinK?
 
Without reading the actual report and looking at 'procedures performed' I agree with most of the codes.

34825 - as long as an extension was really placed and this is not the deployment of the right side limb, I know the verbage is confusing but it is important to understand that. Not saying you're wrong - just something to think about

Per Dr. Z: The delivery of the initial contralateral limb (AKA the "docking limb") is not an "extension device" - it completes the graft. Any additions beyond the initial docking limbs are called extensions limbs or cuffs, and regard of the number of extensions delivered in a single vessel, rules allow only one extension code per vessel. There are three vessels possible: the right and left iliac arteries and the proximal aorta.

Also, was there mention of cath placement(s) in the aorta? 36200-50.

You need to capture the cath placement for the selective renals 36262 (drop aorta cath placements, if so)

And lastly, you should not code for angioplasty or stent to prepare the vessel for graft or to fully deploy graft or to seal a graft leak. So as long as the renals and interventions were not done in effort to better deploy the graft, then bill them.

I can send you a cheat sheet for these if you want. I've had it now since 2008. LOL. One of my best friends! Also, Dr. Z's book specifically lists the grafts associated with codes 34802-34805.
 
that would be great if you send me the cheat sheets, i try to read everything i can about vascular coding. thanks for your help
 
You must log in or register to reply here.
Top