ZHealth Special Edition Newsletter

Jan 20, 2017

Special Edition Newsletter: Moderate Sedation

Professional Billing of Moderate Sedation by the Physician Performing the Procedure When in a Facility Site of Service

In the physician RVU file there is a column labeled “PCTC IND” which designates when a code is technical-only or professional-only. The add-on code for each additional 15 minutes of moderate sedation by the physician performing the procedure (99153) is indicated as technical-only (3) in this field. In addition, there is an NA in the RVU file column titled “FACILITY NA INDICATOR”. The NA indicates “that this procedure is rarely or never performed in the facility setting”. Since code 99153 is technical only, a physician cannot report this code when performed in the facility setting.  

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moderate, sediation, professional, billing, physician, procedure, site, service, hospital, mue, indicator

ZHealth Coding Newsletter - December 2016

Dec 29, 2016

December 2016 Q & A

Question: Fractional Flow Reserve without Catheterization

Physician performs LHC at another facility and then transfers the patient to the cath lab at the hospital to perform fractional flow reserve (93571). The physician thinks that 93571-26-XE will get us paid by Medicare and for commercial insurance to bill coronary angiography only with 93571 to get paid.
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catheterization, fractional, flow, reserve, LHC, coronary, angiography, FFR, code, hospital, angiogram, OP, lab

Job Posting

Dec 29, 2016

ADVOCATE, a growing Fortune 5000 healthcare medical billing company, is looking for a part-time Interventional Radiology Medical Coder.

ADVOCATE Radiology Billing & Reimbursement Specialists is an innovative leader in the national radiology reimbursement and management sector of healthcare. We contribute outstanding technical insight with client-friendly services to help our clients achieve optimal top line revenue performance. Visit www.radadvocate.com for more information.

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coder, medical, hiring, part-time, interventional, radiology

ZHealth Coding Newsletter - November 2016

Nov 28, 2016

November 2016 Q & A

Question: Cutting Angioplasty with Perforation

Under fluoroscopic guidance, the upper arm dialysis access fistula was catheterized and fistulogram was obtained. There was a greater than 50% stenosis within the mid cephalic vein that was dilated with an 8 mm angioplasty balloon and high pressure angioplasty balloon with no effect. The lesion was then dilated with a cutting balloon. Following angioplasty with a cutting balloon there was a leak identified from the cephalic vein. Multiple attempts at balloon tamponade were performed, and these were unsuccessful at controlling the leak. An 8 mm x 6 cm fluency stent graft was then placed across the leak and dilated to 8 mm. Follow-up fistulogram was obtained and showed free flow of contrast through the stent. Cephalic arch and central veins are patent. The arterial anastomosis is widely patent. There is a small pseudoaneurysm in the cephalic vein near the arterial anastomosis.
I am assigning codes 36147 and 37238. Should something be stated about the perforation? If so, how should this be coded?

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angioplasty, perforation, fluoroscopic, dialysis, fistula, catheterized, fistulogram, stenosis, vein, balloon, stent, code

ZHealth Coding Newsletter - October 2016

Oct 25, 2016

October 2016 Q & A

Question: Femoral Stent to Stop Bleeding

A patient had a TAVR procedure and had continued bleeding of the femoral artery, so a femoral artery stent was deployed. What code do I use for this service? I see that the CPT book states, "Codes 37220-37235 are to be used to describe lower extremity endovascular revascularization services performed for occlusive disease," so I know that these codes do not apply since the stent was deployed for hemostasis. Is this a billable service?

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femoral, stent, bleeding, TAVR, procedure, artery, cpt, code, hemostasis, vessel, coils, embolization, occlusive, non-occlusive

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CodingCodeCatheterZhealthArteryCptStentAngiographyAngioplastyEmbolizationArteriesBalloonBillingInterventionalCodesDialysisPlacementMedicalMedicareModifierRadiologyStenosisImaging2016

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