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Here’s your ZHealth Coding Newsletter for
September 2006
Below is a
recent coding question and answer (one of several
hundred posted for ZHealth Online members):
Dr. Z
Coding Question: Hi
Dr. Z, Thanks for a great info site. I am
reviewing a claim in which the MD performed the
following: "Multiple dilations were performed in the
ventral segmental division of the renal artery.
Guidewire was left traversing the ventral segmental
division. A new glide wire was inserted in the dorsal
division of the right renal artery catheterized.
Multiple dilatations of the dorsal segmental division of
the right renal artery were performed." Should this be
reported as one or two angioplasty procedures?
Thanks.
Dr. Z’s
Answer:
I would follow the rules that if a separate catheter
placement code is required, then a separate intervention
may be performed in the peripheral vessels.
For instance, if the anterior tibial, posterior
tibial and peroneal arteries are selected (36247, 36248,
36248) and angioplastied, I would code as many
angioplasties as separately selected vessels: three. If
it were three lesions in a long posterior tibial artery,
it is only one level of catheter selectivity--and so
only one angioplasty. The same applies to the renals. If
the origin of the main renal and the distal portion of
the main renal were angioplastied, I would only code one
as the catheter placement is in only one level of
selectivity. In your case, there was probably
fibromuscular dysplasia extending into two large
branches of the main artery(the second order ventral
division and the additional second or third order
selective dorsal division of the renal
artery). Since the coding of the
catheter positioning would be 36246 and 36248, and
intervention was performed in each vessel, I would code
for two renal angioplasties--the second would be the
additional visceral angioplasty.
ZHealth Coding Conference in Las Vegas,
November 7-10
There’s still
time to sign up for the last ZHealth
Coding Conference of 2006 at the Wynn Las
Vegas, November 7-10. We’re offering special tracks
for every level of interventional radiology or
cardiology coding/billing. And you get a free ($295
value) copy of Dr. Z’s current
Interventional Radiology Coding Series
book with your registration (with the exception of a
half day track registration). In
addition, ZHealth
Online members receive a
10% discount off their registration.
We hope to see you in Las
Vegas!
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