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single stent

Ashley Posted Thu 05th of January, 2017 09:17:39 AM
I need some guidance on how to code a declot where I inserted a single stent that covered both the left axillary and subclavian veins (components of both the peripheral and the central dialysis circuit). Although stenting the axillary and subclavian veins technically is stenting both the peripheral and central dialysis circuits, since I only used one 10 x 80 mm stent I think I can only bill for stenting either the peripheral or the central dialysis circuit but not both simultaneously. One option is to code for thrombectomy and stenting of the peripheral dialysis circuit and also add angioplasty of the central circuit (36906 and 36907) Alternatively I can code for thrombectomy and stenting of the central dialysis circuit and add angioplasty of the peripheral circuit as I did below (36905 and 36908) Which one do suggest? Below is one of our doctors suggestion. This is an interesting question. I reread the book I have and nowhere does it say that one stent equals one code. It clearly states that multiple lesions treated in the same segment fall under one code that is reported once per session, independent of the number discrete lesions treated. Since it so clearly defines the singularity of coding multiple lesions in each segment, but is doesn’t speak to treating multiple segments with the same device, I think we would be justified in coding for 36903 and 36908 in this case. What if you had used two stents and overlapped them you would not have a question. As long as it is well documented that there are lesions involving both segments of the dialysis circuit I think we should be able to bill stent codes for both.
SuperCoder Answered Fri 06th of January, 2017 08:30:23 AM

Hi,

Our experts team is working on the query and will get back soon.

SuperCoder Answered Fri 06th of January, 2017 08:30:24 AM
Hi, Our experts team is working on the query and will get back soon.
SuperCoder Answered Mon 09th of January, 2017 10:09:51 AM

36870 for the declot and stenting.Also,billing of stent or stents requires only one code.

SuperCoder Answered Mon 09th of January, 2017 10:09:51 AM
Hi, Our experts team is working on the query and will get back soon.
Ashley Posted Mon 09th of January, 2017 10:23:08 AM
36870 is no longer for 2017 but stent area was two different segments why only one code?
SuperCoder Answered Tue 10th of January, 2017 02:59:09 AM

Hi,

CPT code combination  36903 and 36908 is appropriate for the above mentioned scenario.

Consider the following :

1) Angioplasty is coded per vessel treated (except the femoral/popliteal territory), not per stenosis.

2) Do not code “pre-dilation” angioplasty prior to stent placement

3) Do not code multiple angioplasties in a single vessel.

 

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