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declotting a surgically created fistula, attempt aborted

Lynn Posted Tue 21st of December, 2010 09:23:35 AM

After "extensive attempts" to declot by Percutaneous transluminal angioplasty of venous fistula of upper arm, multiple angiograms and balloon angioplasties with direct ultrasound were done, there was some improvement but good flow could not be restored so procedure was aborted and entry sites were sutured. A temporary nontunneled dialysis catheter was placed into the jugular vein (different site). Question is, can I still code for the shunt declot, PTA or only the successfull procedure?

SuperCoder Answered Tue 21st of December, 2010 18:42:09 PM

I would like to give you possible scenarios that happens in such cases. You need to evaluate what fits best in the given scenario.

If aborted procedure is the only procedure performed: Use modifier 52 (Not 53) even though the procedures are performed but did not achieve desired results.
If there had been a successful procedure along with an aborted procedure (as in this case):
We should always take option of using modifier 22 along with the successful procedure.

1. Code the successful procedure; and
2. Code the Unsuccessful procedure with modifier 52 with the reason as mentioned in first two lines.

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