David Zielske, MD, CIRCC, COC, CCVTC, CCC, CCS, RCC

About David Zielske, MD, CIRCC, COC, CCVTC, CCC, CCS, RCC

David Zielske is founder and President of ZHealth Publishing and primary author and editor of ZHealth publications. Dr. Z practiced as an interventional radiologist and has over twenty years experience as a coding reviewer and coding expert. He is Board Certified in Radiology and has functioned as an independent interventional radiology, vascular surgery, and cardiovascular coding consultant to a variety of physician groups and hospital providers across the country. He also served as an instructor for over 200 coding seminars. Dr. Zielske can be reached at davidz@ZHealthConsulting.com.

16 04, 2018

CPT Code 36904 – Crisscross Infusion Catheters Placed in an AV Dialysis Fistula

By David Zielske, MD, CIRCC, COC, CCVTC, CCC, CCS, RCC|2020-01-17T16:28:00-05:00April 16th, 2018|Coders' Corner|Comments Off on CPT Code 36904 – Crisscross Infusion Catheters Placed in an AV Dialysis Fistula

ZHealth Publishing Coding Q&A Libman Education is proud to offer ZHealth Publishing’s broad range of coding products to assist both the novice and the seasoned coder to become experts at coding and charging for complex procedures in Interventional Radiology, Interventional Cardiology, Vascular/Endovascular Surgery, and Diagnostic Radiology. Periodically, ZHealth Publishing experts offer general recommendations in response to specific customer inquiries. by David Zielske, MD, CIRCC, COC, CCVTC, CCC, CCS, RCC Question: How would you bill for crisscross infusion catheters placed in an AV dialysis fistula? Fistulogram showed thrombus within AV fistula with total occlusion. Successful crisscross placement of 5 F

22 12, 2017

Infrarenal AAA

By David Zielske, MD, CIRCC, COC, CCVTC, CCC, CCS, RCC|2020-01-17T16:30:25-05:00December 22nd, 2017|Coders' Corner|Comments Off on Infrarenal AAA

My provider did infrarenal AAA, using US guidance, he accessed both femoral arteries. He deployed a Gore endovascular stent with careful attention not to encroach the left renal artery. Then, the Gore limb was ...

10 11, 2017

Can you bill 61635 and 61624 for the stent assisted coiling?

By David Zielske, MD, CIRCC, COC, CCVTC, CCC, CCS, RCC|2020-01-17T16:33:04-05:00November 10th, 2017|Coders' Corner|Comments Off on Can you bill 61635 and 61624 for the stent assisted coiling?

Question: Can you bill 61635 and 61624 for the stent assisted coiling?

27 10, 2017

AV Fistula Declot & Stenting Failure; TPA and Repeat Stent for Extravasation

By David Zielske, MD, CIRCC, COC, CCVTC, CCC, CCS, RCC|2020-01-17T16:35:03-05:00October 27th, 2017|Coders' Corner|Comments Off on AV Fistula Declot & Stenting Failure; TPA and Repeat Stent for Extravasation

AV left forearm graft fistulogram showed extensive thrombus in main draining vein up to the level of the distal third of the humerus. Crossing sheaths placed. Angiojet catheter used to treat arterial and venous anastamosis. It worked for arterial but not venous. Angioplasty of arterial anastomosis, with arterial flow re-established. Stent was placed ...

5 10, 2017

EVAR Repair with Deployment of 2 Gore Excluder Limbs

By David Zielske, MD, CIRCC, COC, CCVTC, CCC, CCS, RCC|2020-01-17T16:33:41-05:00October 5th, 2017|Coders' Corner|Comments Off on EVAR Repair with Deployment of 2 Gore Excluder Limbs

I am not sure how to code for a second graft in this case or if I can code for it at all because I am not positive that the second graft is considered a separate vessel and qualifies for the 34826. There is no mention of it being placed in either the external or internal iliac.

25 08, 2017

Superior Mesenteric Artery to Rt Hepatic Artery

By David Zielske, MD, CIRCC, COC, CCVTC, CCC, CCS, RCC|2020-01-17T16:37:12-05:00August 25th, 2017|Coders' Corner|Comments Off on Superior Mesenteric Artery to Rt Hepatic Artery

Can a catheter reach the right hepatic artery from the SMA or does the catheter need to go through the celiac artery?

6 07, 2017

Coarctation of Aorta and Bicuspid Aorta Valve

By David Zielske, MD, CIRCC, COC, CCVTC, CCC, CCS, RCC|2020-01-17T16:37:35-05:00July 6th, 2017|Coders' Corner|Comments Off on Coarctation of Aorta and Bicuspid Aorta Valve

In the introductory section to Cardiac Catheterization in the CPT codebook, it states: Anomalous coronary arteries, patent foramen ovale, mitral valve prolapse, and bicuspid aortic valve are to be reported with ...

1 06, 2017

96374 with an Ablation

By David Zielske, MD, CIRCC, COC, CCVTC, CCC, CCS, RCC|2020-01-17T16:38:14-05:00June 1st, 2017|Coders' Corner|Comments Off on 96374 with an Ablation

Injections performed during an invasive procedure are not reported separately. From the NCCI Manual: ...

11 05, 2017

Chronic Total Occlusion

By David Zielske, MD, CIRCC, COC, CCVTC, CCC, CCS, RCC|2020-01-17T16:41:51-05:00May 11th, 2017|Coders' Corner|Comments Off on Chronic Total Occlusion

Since a CTO is a CHRONIC total occlusion, does it need to be staged? They would know about it ahead of time, since it is chronic. But what if the doctor finds a CTO upon first ...

27 04, 2017

Left Dorsalis Pedis an Additional Artery on Left Anterior Tibial?

By David Zielske, MD, CIRCC, COC, CCVTC, CCC, CCS, RCC|2020-01-17T16:41:31-05:00April 27th, 2017|Coders' Corner|Comments Off on Left Dorsalis Pedis an Additional Artery on Left Anterior Tibial?

Is the left dorsalis pedis angioplasty an add-on to code 37229, or is it part of code 37229? Is just code 37229 reported, or 37232 and 37229?

30 03, 2017

Treating Tibioperoneal Trunk with PTA and SFA

By David Zielske, MD, CIRCC, COC, CCVTC, CCC, CCS, RCC|2020-01-17T16:40:57-05:00March 30th, 2017|Coders' Corner|Comments Off on Treating Tibioperoneal Trunk with PTA and SFA

I would code 37224 for the SFA angioplasty and 37228 for the tibioperoneal trunk angioplasty. Had this been a popliteal angioplasty bridging into the TP trunk, I would only submit ...

2 03, 2017

C2623 vs 37220

By David Zielske, MD, CIRCC, COC, CCVTC, CCC, CCS, RCC|2020-01-17T16:45:42-05:00March 2nd, 2017|Coders' Corner|Comments Off on C2623 vs 37220

We have been getting edits when codes C2623 (Catheter, transluminal angioplasty, drug-coated, non-laser) and 37220 (Revascularization, endovascular, open or percutaneous, iliac artery, unilateral, initial vessel; with transluminal angioplasty) are on the same claim, but I can find nothing to ...

17 02, 2017

Does a CTO 92943 Have to be Staged?

By David Zielske, MD, CIRCC, COC, CCVTC, CCC, CCS, RCC|2020-01-17T16:46:32-05:00February 17th, 2017|Coders' Corner|Comments Off on Does a CTO 92943 Have to be Staged?

Since a CTO is a CHRONIC total occlusion, does it need to be staged? They would know about it ahead of time, since it is chronic. But what if ...

13 02, 2017

Professional Billing of Moderate Sedation by the Physician Performing the Procedure When in a Facility Site of Service

By David Zielske, MD, CIRCC, COC, CCVTC, CCC, CCS, RCC|2020-01-17T16:47:10-05:00February 13th, 2017|Coders' Corner|Comments Off on Professional Billing of Moderate Sedation by the Physician Performing the Procedure When in a Facility Site of Service

The codes for reporting moderate sedation performed by a physician or other qualified health care professional other than the one performing the procedure do not have different RVUs for the ...

3 02, 2017

Code 32551 vs Code 32557

By David Zielske, MD, CIRCC, COC, CCVTC, CCC, CCS, RCC|2020-01-17T16:53:32-05:00February 3rd, 2017|Coders' Corner|Comments Off on Code 32551 vs Code 32557

Code 32557 describes the placement of an indwelling catheter into the pleural space with imaging guidance for drainage of air (pneumothorax), fluid or infection, and covers this procedure. Code 32551 is for “OPEN”...

12 01, 2017

Fractional Flow Reserve without Catheterization

By David Zielske, MD, CIRCC, COC, CCVTC, CCC, CCS, RCC|2020-01-17T16:50:16-05:00January 12th, 2017|Coders' Corner|Comments Off on Fractional Flow Reserve without Catheterization

Physician performs LHC at another facility and then transfers the patient to the cath lab at the hospital to perform fractional flow reserve (93571). The physician thinks that 93571-26-XE will get us paid by Medicare and for commercial insurance to bill coronary angiography only with 93571 to get paid.

30 12, 2016

Cutting Angioplasty with Perforation

By David Zielske, MD, CIRCC, COC, CCVTC, CCC, CCS, RCC|2020-01-17T16:52:11-05:00December 30th, 2016|Coders' Corner|Comments Off on Cutting Angioplasty with Perforation

I am assigning codes 36147 and 37238. Should something be stated about the perforation? If so, how should this be coded?

1 12, 2016

Brachial Cutdown Not Involving AAA Repair

By David Zielske, MD, CIRCC, COC, CCVTC, CCC, CCS, RCC|2020-01-17T16:57:40-05:00December 1st, 2016|Coders' Corner|Comments Off on Brachial Cutdown Not Involving AAA Repair

I have used 34834 for a brachial artery cutdown for AAA repair. Can you please advise on CPT Code for cutdown of brachial artery for repair of SFA aneurysm with a Viabahn Stent?

10 11, 2016

Femoral Stent to Stop Bleeding

By David Zielske, MD, CIRCC, COC, CCVTC, CCC, CCS, RCC|2020-01-17T16:56:53-05:00November 10th, 2016|Coders' Corner|Comments Off on Femoral Stent to Stop Bleeding

I would recommend using CPT code 37236 for the placement of a stent (or stentgraft) when the device is placed to treat a bleeding vessel. Had this hemorrhaging vessel been somehow treated with coils, it would be coded as an embolization with CPT code 37244. If both coils ...

1 11, 2016

Embolization – 37241 for Lymphatic Malformation Treatment

By David Zielske, MD, CIRCC, COC, CCVTC, CCC, CCS, RCC|2020-01-17T17:01:02-05:00November 1st, 2016|Coders' Corner|Comments Off on Embolization – 37241 for Lymphatic Malformation Treatment

Non-selective catheter placements cannot be submitted with embolization procedures (see the National Correct Coding Initiative Manual for Medicare Services). The procedure performed is an ...