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Peripheral Procedural Coding in the
Cardiac Cath Lab (Part II) –Interventions (Oct
17th)
Electrophysiology, Pacemaker and
Defibrillator Coding (Nov 29th)
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Here is
your ZHealth Coding Newsletter for October
2007
The following is a
recent coding question submitted by one of our
ZHealth
Online
members and Dr. Z’s answer:
Coding
Question
I code for a physician
who frequently performs thoracic aneurysm. Endograft
placement (33881 + 75957). With these, the physician
often performs a selective celiac catheterization and
angiography. I typically code the celiac catheterization
(36245) for these cases, but I do not assign the celiac
angiography code (75726), as usually the patient has had
a previous diagnostic celiac angiography and does not
meet the criteria for coding a second celiac angiography
with the endograft placement study. I explained to my
physician that all imaging necessary to complete the
endograft placement is included in the S&I code for
the TAG. My physician has stated that
75726 should also be billed, as he states that he has to
inspect and interpret the celiac angiogram after the TAG
endograft is deployed to be sure it does not occlude the
celiac artery. What are your thoughts? Is 75726
inclusive to the S&I code for the graft placement?
Your advice is greatly appreciated. Thank
you!
Dr. Z’s
Answer
As you stated, all
imaging associated with thoracic stent graft placement
is bundled into the S&I codes for the stentgraft
placement. In this case, it sounds a
lot like the celiac angiogram is a part of his
stentgraft placement routine, which would make this
bundled -- kind of like checking the distal runoff
after a stent placement in the iliac or sfa, to be sure
you didn't embolize down the leg. This is bundled and
not separately billable. Follow-up imaging after most
interventions (other than infusion therapy and
embolotherapy where 75898 would be appropriate) is a
bundled component of the procedure. I agree with your
coding for the catheter placement but not the imaging in
this case.
New ZHealth Web Seminars
Wednesday October 17,
2007
Thursday November 29,
2007
Noon
CST
Peripheral
Procedural Coding in the Cardiac Cath Lab (Part II)
–Interventions (October 17,
2007)
Electrophysiology, Pacemaker and Defibrillator
Coding (November 29,
2007)
Learn on your
lunch hour, earn your CEU’s, and avoid the travel
expense.
- View these live
90-minue audio interactive presentations via the
Internet – during your lunch hour (noon
CST). The final 15 minutes of the session
will be reserved for a live, open forum participant Q
& A session.
- Invite as many
attendees as you like for the cost of
$259/site for a single course or $389/site for
both courses (plus 10% additional discount available
to ZHealth Online members.
- Earn up to 2
(two) society-approved CEU credits (AHIMA, AAPC, ASRT,
RCC) for each attendee) per individual course.
- Also, optionally
purchase CD’s of these presentations (and previous
web seminars) for future reference and continued
learning at your facility ($259@) – and still earn
your CEU’s.
Note that it
is not necessary that you attended Part I of our
Peripheral Procedural Coding in the Cardiac Cath
Lab - Diagnostic Angiography & Catheter
Selections to attend Part II next
week (and you can alway purchase the
CD).
Featuring:
David Zielske MD, CSS, CPC-H,
RCC and David Dunn MD, FACS, CSS,
CPC-H, RCC
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