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by David Zielske, MD, CIRCC, COC, CCVTC, CCC, CCS, RCC For the following dictation, what can be coded? “Procedure: Fluoroscopy guided radiofrequency ablation at right sacral ala and lateral branches at S1, S2, and S3 (12 sites). Detail: Following informed consent, and with the patient under general anesthesia, she was prepped and draped in usual […]

by David Zielske, MD, CIRCC, COC, CCVTC, CCC, CCS, RCC Question: Coding for 93623 Is the documentation below sufficient to code 93623? Would you please explain why or why not? “Bi-directional block was demonstrated in and out of all 4 pulmonary veins post ablation. Adenosine was administered in 9 mg boluses to check for dormant […]

by David Zielske, MD, CIRCC, COC, CCVTC, CCC, CCS, RCC Question: 61624 – CNS Embolization Right Internal Carotid Artery I’m looking for clarification on the catheter placement for the above procedure. I understand a true diagnostic angio is separately billable, but somewhere along the line, I thought that when there is no diagnostic angio that […]

by David Zielske, MD, CIRCC, COC, CCVTC, CCC, CCS, RCC Question: SPINRAZA INJECTION I am seeing two opinions on how to bill this. The first way is to bill with CPT code 62323 [Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, […]

by David Zielske, MD, CIRCC, COC, CCVTC, CCC, CCS, RCC Question: Heart Cath with IMA Coil Embolization Please see following medical record: Right and left congenital heart catheterization; angiography of the SVC; imaging of the left PA, RIMA and LIMA; followed by coil embolization of both the RIMA and the LIMA. Can we report 37242 […]

by David Zielske, MD, CIRCC, COC, CCVTC, CCC, CCS, RCC Question: Lumbar Artery Arteriography Is arteriography for the lumbar arteries subjective to the reason for the exam? We sometimes see the doctors select L1-L4 and branches off the lumbar arteries to look for bleeds. If the dx is Flank hematoma from a fall and they […]

by David Zielske, MD, CIRCC, COC, CCVTC, CCC, CCS, RCC Question: Percutaneous Aspiration Ovarian Cyst Is CPT code 58805 or 10160 most appropriate for the following? TECHNIQUE: Percutaneous ultrasound-guided aspiration through 5 French Yueh catheter. Sterile; 1% lidocaine for local anesthesia. Location: Left lower abdominal quadrant and right lower abdominal quadrant. Needle size: 5 French […]

by Gail I. Smith, MA, RHIA, CCS-P I recently heard from a CPT coder who asked: “I am having trouble coding an appendectomy converted to open appendectomy with partial cecectomy. I am thinking you would use 44950-22. The 22 modifier captures the partial cecectomy. Am I correct?” We need to know more about the patient’s […]

by Gail I. Smith, MA, RHIA, CCS-P I am fan of old movies. Every Christmas, I watch The Lemon Drop Kid (1951) that stars Bob Hope and Marilyn Maxwell. This little-known movie with a thin plot introduced the classic Christmas song “Silver Bells.” There is another song in the movie that reminds me of CPT. […]

by Gail I. Smith, MA, RHIA, CCS-P CPT was first published in 1966. In 1966, healthcare was less complex and so was CPT. Let’s fast forward to 2019, we communicate faster and differently than 50 years ago. We now consume lots of information in short bites. Twitter expanded the limit of a tweet to 280 […]

by David Zielske, MD, CIRCC, COC, CCVTC, CCC, CCS, RCC Question: WavelinQ System We have implanted a WavelinQ device but are not sure how to code this procedure. There is a supply C-code available, but we don’t know which CPT code to use. Answer: The WavelinQ is fairly new technology for creating an AV dialysis […]

by Gail I. Smith, MA, RHIA, CCS-P Like many coding professionals, I work with CPT every day. I have accepted the fact that as a code set it is a bit messy and frustrating at times. The updates are often controlled by the individual medical societies and I am not sure any coding professionals are […]

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 Kim Huey, MJ, CHC, CPC, CCS-P, PCS, CPCO, COC KGG Coding and Reimbursement Consulting, LLC I’m working with two different cardiovascular group practices right now – and they both have an incorrect understanding of coding diagnostic caths with an intervention. One practice ALWAYS codes the diagnostic with the intervention, and the other practice NEVER does. […]

by Gail I. Smith, MA, RHIA, CCS-P When fall is in the air, the anticipation of new/revised CPT codes awaits. When I first opened the CPT 2019 code book, I glanced at the expansion of fine needle biopsy codes and then went on to peruse the range of skin biopsy codes based on technique. The […]

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. […]