Ask Dr. Z

The vascular surgeon was called into the cardiology case for a placement of the Impella (33990), requiring placement of a 14 French for the cardiologist to be able to place the Impella in a high risk patient. Code 34713 is only allowable with TAVR, EVAR, FEVAR, and TEVAR procedures. It would not be an allowable separately reportable service for the vascular surgeon, or as an add-on to the Impella. Would they both share code 33990 with either an -81 or -82 modifier for the vascular surgeon for the placement of the 14 French sheath, or would the vascular surgeon not be able to bill for the Impella at all?