CPT® 2016: Urinary Interventional Coding

CPT® 2016: Urinary Interventional Coding

Part 1: Understand what changes affect percutaneous urinary interventional coding.

For 2016, the biggest CPT® coding changes affecting interventional radiology occur within the subspecialties of urinary, biliary, and
neurologic intervention. This month, let’s focus on percutaneous urinary interventional coding, and in upcoming articles we’ll cover biliary and neurologic intervention codes.

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ZHealth Coding Newsletter - March 2016

March 2016 Q & A

Question: Angioplasty or Primary Thrombectomy with No Stenosis Documented

Patient is on Day 2 of lower extremity arterial thrombolysis with EKOS catheter. The patient was placed on the angio table and the catheter was injected showing significant residual heavy clot burden. The physician ballooned the thrombus in the anterior tibial, posterior tibial and peroneal arteries with a 3mm balloon, then used an aspiration catheter in each vessel post ballooning due to loose clot seen within these vessels. There is no physician documentation of any underlying anatomical stenosis in these vessels. Thrombolysis was restarted with the EKOS catheter and sent to the floor for overnight monitoring. On Day 3, the patient is brought back for AngioJet thrombectomy, repeat ballooning of the peroneal along with thrombolytic spray through the AngioJet for 20 min. This is repeated in the posterior tibial artery. Follow-up angiography demonstrates a flow limiting dissection requiring stent placement.

Day 2 was coded as ...

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ZHealth Coding Newsletter - February 2016

February 2016 Q & A

Question: Vasospasm

Six vessel diagnostic cerebral exam performed. Decision made to treat vasospasm of RICA & LICA. Discussion is whether or not the catheter selections for the bilateral ECA vessel selections are still chargeable since the catheter selections of the RICA & LICA are bundled into 61650. I don't feel they are since they are add on codes to 36224, bilateral in this case.
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ZHealth Coding Newsletter - January 2016

January 2016 Q & A

Question: 50435 and 50693

I have a doctor that did a left nephrostogram, ureteral stent insertion and a nephrostomy tube exchange at the same setting. With the new 2016 codes, there is no scenario with a pre existing nephrostomy tract tube exchange and a placement of ureteral stent. I am getting a CCI edit for 50435 saying it shouldn't be billed with 50693. Am I missing something, or misinterpreting something? Would you bill 50693, 50435-XU? Payer is Medicare.
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