http://www.supercoder.com/forum/ Supercoder - Ask an Expert? Forum: Cardiology Coding - Recent Topics en Sun, 12 Feb 2012 12:41:31 +0000 http://www.supercoder.com/forum/topic/a9505#post-11330 Fri, 10 Feb 2012 18:07:06 +0000 lawrence kanter 11330@http://www.supercoder.com/forum/ <p>Medicare, here in florida have been denying cpy code A9505 with adjustment code N362, which means exceeds maximum units per day. we have always used 1 unit at 100.00 and we use 5 units(500.00) now, as of 01/01/12 it is being denied, I called the local medicare and the woman answering the phone told me that is was an unpublished edit that was activated 01/01/12, but she could not tell me how many units i can use or where i can find the answers to this questions, oh yeah, she said i could appeal it or make corrections and re-file but she could not tell me how many units are exceptable now, anyone have any answers,please help!!! Desperate!! </p> http://www.supercoder.com/forum/topic/iliac-artery-angiography#post-11316 Fri, 10 Feb 2012 06:37:35 +0000 Nancy Kim 11316@http://www.supercoder.com/forum/ <p>My physician is planning to perform left iliac artery angiography followed by stent placement. I need cpt codes to obtain preauthorization from patient HMO. Please let me know asap. </p> http://www.supercoder.com/forum/topic/stress-test-interpretation-only#post-11270 Wed, 08 Feb 2012 19:35:20 +0000 Jacquelin Underwood 11270@http://www.supercoder.com/forum/ <p>To bill for 93018, does the dr have to include diagnosis or reason for exam even if he is not the ordering physican? Can we use 93018 to bill for just his interpretation? Thanks </p> http://www.supercoder.com/forum/topic/av-optimization-echo-for-biv-icd#post-11292 Thu, 09 Feb 2012 16:23:33 +0000 Jacquelin Underwood 11292@http://www.supercoder.com/forum/ <p>How do I code an echo done at the hospital by cardiologist as an AV optimization study for timing and synchronization of a biV ICD? I think I would need to code a limited echo and device interrogation? Thanks </p> http://www.supercoder.com/forum/topic/thrombolysis-coronary-during-lhc-and-intervention#post-11258 Wed, 08 Feb 2012 16:39:03 +0000 suzanne cassimore 11258@http://www.supercoder.com/forum/ <p>Is there a code for performing angiography through existing catheter for follow up. Doc did LHC (<code>93458-26</code>), IVUS coronary (+<code>92978</code>) and Thrombolysis coronary <code>92975</code>. Is <code>75898</code> only for peripheral or can be used for coronary as well?</p> <p>Thank you<br /> Julie Agus </p> http://www.supercoder.com/forum/topic/aortogram-and-removal-of-foreign-body#post-11251 Wed, 08 Feb 2012 00:20:14 +0000 Jami Deerfield 11251@http://www.supercoder.com/forum/ <p>Need help coding this procedure.</p> <p>Procedure performed<br /> Aortogram<br /> Removal of foreign body</p> <p>The bilateral groins were prepped and draped in standard surgical fashion. Attention was placed to the left groin where under ultrasound guidance, the common femoral artery was accessed. A lot of plaque was noted around the vessel. The access was successful, and a micropuncture 5 french sheath is introduced into the patient's groin. It was noted at the time that the end of the micropuncture wire unraveled and sheared off with the remnant left within the iliac and common femoral artery. At that point a wire was introduced in the UF and an aortogram was performed demonstrating complete occlusion of the right common external iliac vessels with reconstitutin of profunda femoral and common femoral artery through collaterals. The patient's right hypogastric is also out. The pelvis is being fed by a large sacral vessel as well as a diseased left hypogastric. A snare was used to retrieve the foreign body which was successfully retrieved. The patient received no heparin during the procedure. </p> http://www.supercoder.com/forum/topic/upgrade-single-to-biv-pacer-no-atrial#post-11200 Mon, 06 Feb 2012 16:07:03 +0000 Carol Wright 11200@http://www.supercoder.com/forum/ <p>MD placed an LV lead, removed a single pacer generator, placed a BiV pacer generator; connected the existing RV lead &amp; the new LV lead and capped the atrial port.</p> <p>I can't find this combo in the new codes?! Can I bill 33214 and 33225 even though the only new lead placed was the LV lead?</p> <p>TIA,<br /> Carol Wright, CPC </p> http://www.supercoder.com/forum/topic/cardiac-cath-question#post-11253 Wed, 08 Feb 2012 15:11:15 +0000 AnnMarie Piscopo 11253@http://www.supercoder.com/forum/ <p>When billing for the LHC 93458, PTCA 92982 &amp; FFR wire flow 93571, does the 93571 require modifier? We receive denials for this code to be billed with a primary procedure &amp; I'm guessing the 93571 is not grouping to the 93458? Cannot seem to get this code paid. HELP! </p> http://www.supercoder.com/forum/topic/93015-circumstances#post-11244 Tue, 07 Feb 2012 21:14:00 +0000 Jacquelin Underwood 11244@http://www.supercoder.com/forum/ <p>Would a cardiology office ever use 93015 to code a stress test performed in the hospital with hospital equipment and WITHOUT the cardiologist present? I thought this code was for stress tests performed in the office, not hospital, and that the doc had to be present. I would use 93018 to code his report. Thanks. </p> http://www.supercoder.com/forum/topic/assistant-surgeon-1#post-11224 Tue, 07 Feb 2012 15:34:09 +0000 Jami Deerfield 11224@http://www.supercoder.com/forum/ <p>My doctor did the surgery, but had an assistant surgeon, would I bill with modifier 80, or would the other surgeon bill with it? Or is there another modifier I should use showing there was an assistant surgeon? </p> http://www.supercoder.com/forum/topic/cpt-code-35301#post-11185 Sun, 05 Feb 2012 15:42:02 +0000 Jami Deerfield 11185@http://www.supercoder.com/forum/ <p>Is angioplasty included with cpt code 35301? If not what code would I use for carotid angioplasty? The procedure is carotid endarterectomy and patch angioplasty. </p> http://www.supercoder.com/forum/topic/biv-icd-pulse-generator#post-11145 Thu, 02 Feb 2012 22:10:16 +0000 Keven Fischer 11145@http://www.supercoder.com/forum/ <p>If a patient has a BiV ICD pulse generator and the leads are placed in the right and left ventricle does this code as a dual chamber ICD? The definition of dual chamber shows it as having a lead in the ventricle and the atrium. </p> http://www.supercoder.com/forum/topic/cardiac-arrest#post-10873 Thu, 26 Jan 2012 13:51:14 +0000 anthony orlando 10873@http://www.supercoder.com/forum/ <p>This is a cardia arrest patient, the procedures the doctor did for this patient is 1. insertion of the right femoral vein triple-lumen catheter, would you code 35521 and 35500? 2. right femoral arterial line 36620? and 3. Intra-aortic balloon pump 33967. can all these be used or are my codes no appropriate. thanks </p> http://www.supercoder.com/forum/topic/cpt-for-history-physical-done-as-hospital-outpt-followed-by-a-cardioversion#post-11064 Tue, 31 Jan 2012 20:53:23 +0000 Victoria Evenhuis 11064@http://www.supercoder.com/forum/ <p>We've been submitting 99223 as outpt history &amp; physical but Medicare rejected as invalid place of service.As we know its description was Initial hospital care.We want to know the correct cpt especially if there's procedure done the same day e.g.cardioversion, is 92960 correct? What modifier to use?Pls advise!!!!Thank you....... </p> http://www.supercoder.com/forum/topic/cpt-for-office-ekg-technical-component#post-11023 Mon, 30 Jan 2012 22:31:28 +0000 Victoria Evenhuis 11023@http://www.supercoder.com/forum/ <p>Hi! we want to know the correct CPt for EKG done in our office but was interpreted by another provider outside our group,we owned the device. We know that 93000 is an office global code &amp; 93010 done in the hospital but interpreted by our cardiologist.Thank you!ASAP </p> http://www.supercoder.com/forum/topic/implant#post-10993 Mon, 30 Jan 2012 13:49:15 +0000 anthony orlando 10993@http://www.supercoder.com/forum/ <p>hello, implantation of dual chamber ACID would we code the 33249 and a 33225? With the new codes it scares me to mess up, thanks </p> http://www.supercoder.com/forum/topic/peripheral-vas-services#post-10994 Mon, 30 Jan 2012 13:54:09 +0000 anthony orlando 10994@http://www.supercoder.com/forum/ <p>doc is coding 37220 ,37221 iliac vasc territory. he has also added 36246 with 36140, common iliac ipsilateral and iliac external and internal contralateral..Does the 37220 with the 37221 take over seeing it is all in the iliac vascular territory? he has also added 75716 lower extremity bilateral with each additional selective angio after basic 75774, still not totalling understanding the perip side of things. I know the non selective and the sedation are bundled in. help, thanks </p> http://www.supercoder.com/forum/topic/aicd#post-10920 Fri, 27 Jan 2012 13:34:36 +0000 anthony orlando 10920@http://www.supercoder.com/forum/ <p>The doctor performed 5 steps in his operation, I was wondering how I would code this. 1. Automatic ICD ventricular lead revision.<br /> 2. Removal of malfunctioning ventricular lead.<br /> 3. Revision of AICD pocket.<br /> 4. Reimplantation of AICD<br /> 5. Testing of the AICD with defibrillation testing? Would I code 33223-33226 and 93641 and would I use modifers? thanks </p> http://www.supercoder.com/forum/topic/ivus-interpretation-coding#post-10928 Fri, 27 Jan 2012 15:18:11 +0000 AnnMarie Piscopo 10928@http://www.supercoder.com/forum/ <p>In regard to billing for IVUS- when billing for the IVUS interp 75945 should there be a 26/59 modifier appended or is it not necessary? We have been getting denied by some ins co's stating proc is experimental in nature or that it is included ( we have billed with &amp; without the modifiers in this instance) but will pay the IVUS! Doesnt make sense to me! </p> http://www.supercoder.com/forum/topic/insertion-of-temporary-pacemaker-at-the-time-of-icd-pulse-generator-replacement#post-10938 Fri, 27 Jan 2012 16:53:26 +0000 Trial Account 10938@http://www.supercoder.com/forum/ <p>Our physican performed an ICD Bi-V replacement of the pulse generator only, for a pacemaker dependent patient whos ICD was at the end of its battery life. Are we able to bill the temporary pacemaker insertion code? Or is it bundled with the replacement of the ICD pulse generator? </p> http://www.supercoder.com/forum/topic/closure-of-a-fasciotomy#post-10771 Tue, 24 Jan 2012 00:08:19 +0000 Jami Deerfield 10771@http://www.supercoder.com/forum/ <p>My doctor did the entire fasciotomy and now he did the closure, is there a cpt code for the closure, or is it included? </p> http://www.supercoder.com/forum/topic/question-not-answered-its-been-4-days#post-10958 Sat, 28 Jan 2012 17:09:36 +0000 Jami Deerfield 10958@http://www.supercoder.com/forum/ <p>See question from 4 days ago </p> http://www.supercoder.com/forum/topic/femoral-to-femoral-bypass-same-side#post-10930 Fri, 27 Jan 2012 15:54:01 +0000 Charlene Smith 10930@http://www.supercoder.com/forum/ <p>How is a femoral to femoral (same side)synthetic bypass graft coded? </p> http://www.supercoder.com/forum/topic/lcds-93306#post-10922 Fri, 27 Jan 2012 13:49:49 +0000 Teresa Crawley 10922@http://www.supercoder.com/forum/ <p>(93306), Anyone have a good diagnosis for the Echocardiography? Humana, ha ha ha is denying when filing with 786.50 which is on the cross walk.<br /> Thanks </p> http://www.supercoder.com/forum/topic/tee#post-10919 Fri, 27 Jan 2012 13:19:33 +0000 anthony orlando 10919@http://www.supercoder.com/forum/ <p>The doctor did a TEE which I would code 93312-26, 93320-26 and 93325-26,<br /> He also did defibrillator testing. 93461,<br /> and then Induction and termination of ventricular fibrillation. I am not sure if I code the termination?<br /> Thanks</p> <p>and </p> http://www.supercoder.com/forum/topic/dx-code-for-stent-fracture-and-subintimal-dissection#post-10875 Thu, 26 Jan 2012 14:46:42 +0000 Maria Minnick 10875@http://www.supercoder.com/forum/ <p>Physician performs IVUS and reports that IVUS demonstrates stent fracture and subintimal dissection of the LAD. Physician then stents the LAD. What dx code(s) would I use for the stent fracture and subintimal dissection?</p> <p>Thank you,</p> <p>Maria L. Minnick </p> http://www.supercoder.com/forum/topic/ivc-filter#post-10872 Thu, 26 Jan 2012 13:42:30 +0000 anthony orlando 10872@http://www.supercoder.com/forum/ <p>Our Doctor did an IVC filter placement, the old codes were 37620-75940, I was wondering if the new code would be 37191-26, also included with the filter is venography 75825 and intro cath 36010 with intro sheath extremity venous 36005 can all of these be used or is this a bundled issue in 2012,<br /> thanks </p> http://www.supercoder.com/forum/topic/pacemaker#post-10836 Wed, 25 Jan 2012 18:12:38 +0000 anthony orlando 10836@http://www.supercoder.com/forum/ <p>When the doc puts: 1. explantation of old automatic implantable cardioverter-defibrillator pulse generator which is an ERI.<br /> 2. Revision of the automatic implantable cardioverter-defib pocket.<br /> 3. reimplantation of new automatic implantable cardioverter-defibrillator pulse generator.<br /> 4. DFT testing<br /> 5. Fluoroscopy of the automatic implantable cardioverter-defibrillator and lead system. done 12/30/11. before the 2012 change would I be coding 33240,33241-51, 93641 and 71090-26. thanks for the help and with the new codes for 2012 the fluoroscopy is now bundled. </p> http://www.supercoder.com/forum/topic/code-for-insertion-of-dual-chamber-pacemaker#post-10663 Thu, 19 Jan 2012 17:13:52 +0000 Beverly Gudgel 10663@http://www.supercoder.com/forum/ <p>Is the only code for insertion of a dual chamber pacemaker 33208 since 71090 has been deleted. </p> http://www.supercoder.com/forum/topic/nuclear-stress-coding-question#post-10783 Tue, 24 Jan 2012 15:47:16 +0000 linda. ogilbee 10783@http://www.supercoder.com/forum/ <p>Whats the max units allowed in cpt 'A9505' which is part of a nuclear stress </p>