Ask Dr. Z

I have a patient who had an Embolization of GDA in the morning (9:00 am) but after subsequent flow study there was evidence of extrahepatic flow with MAA injection. On correlation with prior angiogram and CT, it was evident that a unusual branch arising from the cystic artery was supplying extrahepatic omentum;therefore, a decision was made to bring the patient back for embolization of this small branch. In the afternoon (15:00 same day) embolization of an extrahepatic branch arising from the cystic artery was performed. Are we able to bill this additional embolization/cath placements/angio's? I am trying to locate information about how to do this if it is allowed. If so, would we use modifier 59 on these or 76? It is a repeat embolization but of a different area and many hours later. Any suggestions would be most appreciated! Thank you,

Additional information received subsequently:

I should have inquired about cath placement/imaging as well.  As it turns out this patient did have the sheath still in, so there was not a new access.

Would we be able to bill the cath’s and angio’s for the afternoon procedure?

I really appreciate your assistance!  My co-worker and I are really looking forward to your conference, but it looks like we won’t be scheduled until early next year.