Here is your ZHealth Coding Newsletter for May 2006

Below is one of the recent interventional radiology/cardiology coding questions submitted by a member of ZHealth Online. There are now over 600 searchable Q & A's in the Dr. Z Forum database. Plus, as a member you can access our Case-of-the-Month, ask your own coding questions, receive our biweekly ZHealth Online newsletters (not the same as this newsletter), get 10% discounts on all ZHealth Publishing conferences and publications, and much more. Try ZHealth Online free for a week (note that only paying members can ask coding questions). 

Question:  Dr. Z I'm having a hard time discerning between the graft itself and extensions when it comes to coding from the surgeon's reports. I used your book as a source and understand I am not to code the contralateral limb as an extension, but figuring it out on the report is where I get lost. "The graft was difficult to cannulate contralaterally and for this reason a rim catheter was positioned contralaterally and an end snare removed the foreign body and brought it out through the right  femoral artery access where a 16fr sheath had been positioned. This foreign body removal then facilitated positioning of the contra lateral gate using a 16 mm diameter by 11.5 cm graft and an extension on the right of a 16 by 8.5 and an additional extension of 14 by 8.5cm. Superiorly, a 28 by 37.5 graft was also positioned to nudge both renal arteries to provide aortic extension and all fittings were then ballooned...." So how many extensions does this surgeon indicate and would you recommend coding for the foreign body removal, this seems to be a common practice for this surgeon?   

Dr. Z's Answer: The removal of the foreign body he is talking about is just a technique to retrieve the wire for through and through control of device placements. This is not a foreign body retrieval at all.  It is merely a technique utilized to stabilize his placement of the stentgraft. DO NOT bill 37203 and 75961!  This is bundled and should never be charged.  There never was a foreign body.   The contralateral gate is part of the stent graft device and not separately billable, but his documentation does support placement of the extension device, which is billable.  The additional extension is not billable as it is performed on the same side as the original extension. You may only bill for one extension in the left iliac, one in the right iliac and one in the aorta.  Even if two or three extensions are placed in one iliac, you can only bill one extension as the code is utilized once per extremity.

Dr. Z's 2006 Medical Interventional Radiology Coding Reference

The 2006 Edition of Dr Z's Medical Coding Series: Interventional Radiology Coding Reference is now shipping. Also, remember that as a ZHealth Online member you'll receive a 10% discount off any book order (or conference registration). See the Table of Contents and an example chapter. Your 432 page 2006 Edition includes: 

• New 2006 code changes
• New chapters on Percutaneous Thrombectomy & Neurovascular Interventional procedures
• New codes for intracranial intervention, urologic intervention, kyphoplasty, etc. procedures
• New, and expanded examples
• New and updated coding sheets
• New Terminology section
• ...and much more

Note that there are additional discounts if you order more than two copies of the book. And the 2005 edition is available now for only $75.

Order Your 2006 Edition

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