Ask Dr. Z

Regarding vasospasm during intracerebral intervention, does the provider have to mention that it's not "iatrogenically-induced vasospasm" in order to bill codes 61624 and 61650? "Case background: Ruptured right posterior inferior cerebellar artery. Under roadmapping technique, catheter was advanced over 5 French inner and Bentson guidewire into the right VA. The inner catheter and guidewire were removed and the guide catheter double-flushed with heparinized saline solution and connected to continuous heparinized saline flush. 3 mg of verapamil was slowly infused for ten mins into the right VA for treatment of vasospasm. Endovascular coil embolization of right posterior inferior cerebellar artery aneurysm was then performed." The vasospasm part is where I'm confused to code or not (didn't hit NCCI edits). Is it normal to have vasospasm before any intervention done? Or everytime there's vasospam prior to intervention we can't code the vasospasm? What if the intervention is on left ICA and the vasospasm treated is on left VA... can I code it in this scenario?