December 2014 Q & A

Question: Preoperative Tumor Embolization

The preoperative embolizations are sometimes confusing because they are done for varying reasons. When embolization is arteries supplying tumor, would this be considered Tumor Embolization? Patient has metastatic renal cell carcinoma to femur.

August 2014 Q & A

Question: Liver biopsy with tornado coil placement

Physician performed a percutaneous needle core biopsy of the liver using ultrasound guidance (47000 &76942). At the end of his dictation for the biopsy, he said "An introducing needle was then placed into the lesion. An 8x4 tornado coil was placed through the introducing needle." Can I code for this coil placement, and if so, what code(s) would I use?

May 2014 Q & A

Question: Yttrium-90 intrahepatic embolization, catheter placements bundled by NCCI

Under ultrasound guidance for right common femoral artery access, a catheter was advanced to abdominal aorta and on to superior mesenteric artery where an arteriogram was performed (36245-59 for catheter placement). The catheter was redirected into the celiac artery and the proper hepatic artery was selected (36247-59) where an angiogram was performed.

The catheter was then advanced into ...

Q & A with Dr. David Zielske

Question: Sclerotherapy for Lymphatic Malformations

In the past, the coding recommendation for direct sclerotherapy/embolization of lymphatic malformations was to use unlisted codes. With the new embolization codes for 2014, would 37241 be a possibility for these procedures? I looked at 37244 but since that is referring to extravasation, it doesn't appear to match the intent of the sclerotherapy/embolization. Although 37241 doesn't use the term lymphatics, both the CPT book and CPT Insiders refer to these embolization codes to be used when "arteries, veins, and lymphatics may all be the target of embolization". Would you recommend continuing to use the unlisted codes or using one of the 2014 codes?