1. Christine Burgan
   Posted 4 months ago #
   

   Can you please explain to me on coding for balloon angioplasty when you would consider it "open"? My doctors feel when they use catheters and guidewires to do aorta aneurysm repairs and angioplasty procedures that they should be billed with the "open" code and not the "radiologicial procedure" code. AAA they want "00770", and femoral angioplasty they want "01270". What makes a procedure open???

2. SuperCoder
   Posted 4 months ago #
   

   Catheters and guidewires alone would fall more under percutaneous, pointing more to 01924 and 01926. But a surgeon may use open exposure (such as via femoral cutdown) to allow access to a vessel if the patient requires a large prosthesis, which may certainly be the case for endovascular abdominal repair. There still may be use of catheters and guidewires with the open approach.

   Hope that's of some service,
   Deborah

   Deborah Marsh, JD, MA, CPC, CHONC
   Editor, The Coding Institute

3. SuperCoder
   Posted 4 months ago #
   

   Thanks Deborah. This brings more clarity of understanding to everyone.
   Great!

4. Christine Burgan
   Posted 4 months ago #
   

   Still a little confused, if they make an incision in the thigh or abdomen to access the vein, but do not open the vein, just use a catheter is that "open" or "percutaneous"?

5. SuperCoder
   Posted 4 months ago #
   

   This site offers some good insights into how the two differ: http://www.ctsnet.org/portals/endovascular/nutsbolts/article-8.html

   For percutaneous, the physician still will need to puncture the skin and vessel to insert the catheter into the vessel so it can be maneuvered through the vascular system to the target area. Sometimes "percutaneous" is referred to as minimally invasive, meaning it's not a large incision.

6. Christine Burgan
   Posted 4 months ago #
   

   Thank you for that link, I think I now understand the correct code for each procedure. Printed the article to keep for future reference. Supercoder is a wonderful tool to have, much better thatn the cross coder book!

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