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Items Tagged: angioplasty
Jan 11, 2018
Retroactive Billing Medicare for Drug Coated Angioplasty Balloon Code C2623 with AV Dialysis Intervention Codes
Medicare is allowing pass-through payment for code C2623 with AV dialysis interventions for claims filed retroactively for dates of service from August 25, 2017, through December 31, 2017. Pass-through payment wasn’t made with this combination in 2017 due to Medicare not changing its limited coverage for the catheter’s use only in the femoral popliteal arteries. Effective January 1, 2018, pass-through payment for code C2623 ended.
Sep 28, 2017
September 2017 Q & A
Question: Limbs AV Fistula Declot & Stenting Failure; TPA and Repeat Stent for Extravasation
AV left forearm graft fistulogram showed extensive thrombus in main draining vein up to the level of the distal third of the humerus. Crossing sheaths placed. Angiojet catheter used to treat arterial and venous anastamosis. It worked for arterial but not venous. Angioplasty of arterial anastomosis, with arterial flow re-established. Stent was placed across venous anastamosis to improve outflow. Patient continued to clot despite administration of 10,000 units of heparin during the procedure. Multiple passes again made with the angiojet. Flow was not re-established.
Apr 20, 2017
April 2017 Q & A
Question: Left Dorsalis Pedis an Additional Artery on Left Anterior Tibial?
An angioplasty was performed on the left dorsalis pedis artery...an angioplasty with atherectomy was performed on the left anterior distal tibial artery. Is the left dorsalis pedis angioplasty an add-on to code 37229, or is it part of code 37229? Is just code 37229 reported, or 37232 and 37229?
Feb 25, 2017
February 2017 Q & A
Question: C2623 vs 37220
We have been getting edits when codes C2623 (Catheter, transluminal angioplasty, drug-coated, non-laser) and 37220 (Revascularization, endovascular, open or percutaneous, iliac artery, unilateral, initial vessel; with transluminal angioplasty) are on the same claim, but I can find nothing to indicate that this code pair should create an edit. Edit reads: when C2623 is on the claim then 37224 or 37226 must also be on the claim?
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?