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Viabahn Stent / Angiogram / Angioplasty

Nicole Posted Wed 29th of June, 2016 14:31:25 PM
Insert Viabahn Endovascular stent graft in upper extremity cephalic vein fistula. Balloon Angioplasty Cephalic Vein. Shunt study. Venogram of SVC. Angiogram of radial Artery S&I of Radial Angiogram. Balloon Angioplasty of radial artery. The codes for the above procedures I have are: 37238 (Viabahn Stent includes Angioplasty) _____ (Shunt Study) 36010 & 75827 (Venogram of SVC) 75710 (Angiogram of Radial Artery) 35475 & 75962 (Balloon Angioplasty of Radial Artery) Am I even close to the correct coding, any help would be greatly appreciated!
SuperCoder Answered Thu 30th of June, 2016 03:59:03 AM
CPT code 37238 should be used for stent and angioplasty performed in the same initial vessel. CPT code 36010 is correct code for SVC catheterization with CPT code 75827 - 59 modifier for SVC venography. CPT code 75710-59 modifier is the correct code for radial artery angiography and CPT code 35475 is the correct code for radial artery balloon angioplasty with CPT code 75962 is the correct code for radiological supervision and interpretation. Based on the limited operative note, above mentioned codes seem appropriate for the procedures performed. However, we would appreciate you to provide us with the complete operative report for accurate coding.
Nicole Posted Thu 30th of June, 2016 09:19:03 AM
Is there a CPT code for "Shunt Study". This new doctor seems to have this on his dictations often. I am not sure if it is inclusive with another procedure or if it is separately billable. It seems that it is being done after the balloon angioplasty is performed.
SuperCoder Answered Fri 01st of July, 2016 02:16:52 AM
Evaluation of shunt or shunt study is coded with CPT code 36147 and 36148. While billing CPT code 36147 for shunt study, you should not report a separate code for the following services: Access/imaging: The work of directly accessing and imaging the entire AV shunt is included in 36147. Per the guidelines, the puncture may be antegrade or retrograde, and the physician may inject the contrast through a needle or catheter. Cath manipulation: Catheter advancement in the shunt and/or vena cava is included. The guidelines specify that 36147 includes all manipulation for diagnostic imaging of the shunt. Please find below the SuperCoder article for better understanding: https://www.supercoder.com/coding-newsletters/my-general-surgery-coding-alert/vascular-surgery-36147-details-hone-your-diagnostic-av-shunt-coding-129777-article

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