Leorah Posted Wed 16th of August, 2017 15:19:31 PM
Our Neuro Interventional physician just had a complicated case where a patient had an extracranial embolization and the doctors injected the vertebral artery (61626, 75894, 36226 and 75898). In addition a venography of the right internal jugular vein was performed and we coded a 75860. Lastly, the patient had vasospasm whereby the radial artery was injected till the subclavian artery and verapamil was injected. For that procedure I coded a 61650 and did not code the radial and radiology code since it is included with the 61650 Besides coding the 61650 with a separate ICD code is there anything else I need to do in order to get paid for the 36226 code and the 75860? The insurance company is stating that they are inclusive in the 61650 even though they were part of the embolization.
SuperCoder Answered Thu 17th of August, 2017 03:23:44 AM
Greetings from SuperCoder.com!
There is CCI edit between codes 61650, 36226, and 75860. The insurance company is stating correct and you cannot report 36226 and 75860 with 61650.
You may report 36226 and 75860 with modifier 59 only if your documentation supports that these were performed separately.
Please feel free to write if you have any concern or questions.