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Please Help with Spinal Angio

Leorah Posted Wed 21st of November, 2018 04:03:31 AM
Please help me with the coding this spinal angio: 1) bilateral Catheterization of T4-T12 2) bilateral catheterization of L1-L4 3) Median sacral artery catheterized 4) Left and right internal iliac injected 5) bilateral internal carotid 6) bilateral external carotid 7) bilateral of thryrocervical trunk injected 8) bilateral costo cervical trunk injected 7) bilateral vertebral arteries. Thank you
SuperCoder Answered Thu 22nd of November, 2018 04:03:44 AM

Hi Leorah,

>Since there is a limited information provided above and the procedure performed is not the simple one; so, you may see the below codes and corelate with the complete documentation.

>36215 x18 for Catheterization of bilateral T4, T5, T6, T7, T8, T9, T10, T11, T12

>36245 x 8 for Catheterization of bilateral L1, L2, L3, L4

>36224-50 for Bilateral internal carotid angiograms.

>36227-50 for Bilateral external carotid angiograms.

>36226-50 for Bilateral vertebral angiograms.

>Also, codes for accessing the vessel, placement of the catheter(s), contrast injections, fluoroscopy, radiological supervision & interpretation and closure of arteriotomy are included in above codes.

The above codes are the closest and appropriate codes that were possible to be given as per above provided documentation. Please feel free to ask for any further documentation.

 

Leorah Posted Thu 22nd of November, 2018 07:17:48 AM
Thank you! That is so helpful. I also thought I could code CPT 75705 for the diagnostic imaging for each of the T4-T12 and L1-L4 arteries. Is that correct?
SuperCoder Answered Fri 23rd of November, 2018 02:58:06 AM

Yes, its correct, you can go ahead and bill CPT 75705 as well. Thank you.

Leorah Posted Fri 23rd of November, 2018 04:33:29 AM
Thank you I just realized- you didn't tell me the codes for 1)Left and right internal iliac catheterization and 2)bilateral of thryrocervical trunk
SuperCoder Answered Mon 26th of November, 2018 05:30:29 AM


As per the previous documentation, you have mentioned Left and right internal iliac injected, bilateral of thryrocervical trunk injected, and bilateral costo cervical trunk injected. So, without the proper medical report, it is not possible to give the appropriate code. Also, codes for accessing the vessel, placement of the catheter(s), contrast injections, fluoroscopy, radiological supervision & interpretation and closure of arteriotomy are included in above codes. Thank you.

Leorah Posted Tue 27th of November, 2018 07:47:12 AM
Can I send you the procedure report and I will remove the HIPA information? I really need help on this
Leorah Posted Wed 28th of November, 2018 04:17:41 AM
In addition, if the insurance is a commercial plan am I able to code all 18- 36215 codes even though the MUE's for this code is only 6?
SuperCoder Answered Thu 29th of November, 2018 07:17:18 AM

Hi Leorah,

MUE for CPT 36215 is 6. However, it is allowed to bypass the MUE based on documentation of medical necessity. So you may check with the payer policy and the medical necessity to bill the number of units. Hope it helps. 

 

Leorah Posted Thu 29th of November, 2018 08:02:52 AM
Can I send you the procedure report and I will remove the HIPA information? I really need help on this to find out how to code the Left and right internal iliac injected, bilateral of thryrocervical trunk injected, and bilateral costo cervical trunk injected.
SuperCoder Answered Fri 30th of November, 2018 06:33:59 AM

Hi Leorah,

AAE does not provide coding for operative reports and chart notes.

SuperCoder offers SuperCoding on Demand (SOD) (http://www.supercoder.com/coding-answers/coding-on-demand) for coding of an operative report or chart note and you can contact (866)228-9252 or e-mail customerservice@supercoder.com for more information. Feel free to ask for any further support. Thank you.

 

 

Leorah Posted Mon 03rd of December, 2018 03:20:54 AM
Could you please tell me then how I would code for the Left and right internal iliac injected, bilateral of thryrocervical trunk injected, and bilateral costo cervical trunk injected. Thank you
SuperCoder Answered Wed 05th of December, 2018 03:00:04 AM

Hi Leorah,

As discussed earlier, codes for accessing the vessel, placement of the catheter(s), contrast injections, fluoroscopy, radiological supervision & interpretation and closure of arteriotomy are included in above codes. However, if there is something apart from contrast injections, you may provide us with details of mode, type and indication of injection given. Thank you.

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