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Distal Catheter flush with shunt taps on distal and proximal portions.

Deborah h Posted Mon 23rd of November, 2015 20:06:35 PM

If there was a scenario where the distal catheter was aspirated with a shunt tap and flushed and at the same time a shunt tap was done on the ventricular catheter (proximal portion); then both the distal catheter and proximal was secured back to the connector. Would you code this as an 62230 for irrigation of the distal catheter and then code separately 61070 x2 for two tabs; or would the taps bundle. Please list all cpt codes for this scenario.

SuperCoder Answered Wed 25th of November, 2015 11:05:38 AM

Thanks for your question. You would report 62230; Replacement or revision of cerebrospinal fluid shunt, obstructed valve, or distal catheter in shunt system and 61070; Puncture of shunt tubing or reservoir for aspiration or injection procedure twice. Medically Unlikely Edit or MUEs max at 2 for 61070. Note that CCI column 2 edits exist for 61070 and 62230, so you’ll append modifier 59 (Distinct procedural service) to 61070 if you report this code with 62230. Since the ventricular catheter irrigation is performed through the same exposure as the distal shunt revision, then this would be considered a bundled service. Hope this helps.

Deborah h Posted Wed 25th of November, 2015 17:45:36 PM

Ok, are saying to code 62230, 61070-59, 61070-51 or 62230, 61070-59, 61070-59; however, I still get an edit; use RT, LT, 76, OR 77 modifier for repeat cpt code. Please clarify.

SuperCoder Answered Mon 30th of November, 2015 00:49:31 AM

Depending on the payer you may be able to bill 2 units of 61070 and append modifier 59 or bill 61070 separately (one unit -twice) and append modifier 59 to the first 61070 and modifier 51 to the second 61070. You should check with the payer guidelines to verify their policy on billing multiple units of 61070.

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