HELP? After a stent...

[brandyleigh23]

I have a report that states a stent and angio were done to the LD.

At the end of the procedure he notes that he took a limited right femoral peripheral arteriogram to see if he could put a closure device at the site of the femoral arteriotomy.

However the arteriogram showed that there was a plaque at the site of the sheath insertion. The sheath was left in place and hooked through an A line to be removed 2 hours later.

Should I code for the arteriogram? If yes, what code should I use?

[Jess1125]

My answer is no. Doctor was just doing it to see if he could place a closure device. I would still say no even though the closure device wasn't placed due to the reason above.

The following is from Medicare's NCCI manual
18. Placement of an occlusive device such as an angio seal or vascular plug into an arterial or venous access site after cardiac catheterization or other diagnostic or interventional procedure should be reported with HCPCS code G0269. A physician should not separately report an associated imaging code such as CPT code 75710 or HCPCS code G0278.

Jessica CPC, CCC

[bkiesecker]

oww good question...

My opinion is that since it was not the intent to do a diagnostic angio of the leg i would say no dont bill it .

however playing devils advocate if it was a true diagnostic angio and is not a medicare patient then you would want to look at 75710 ( the doc should tell you about the arterys distal and proximal of the sheath and the extent of the disease )

however if it was me and all he or she stated was that it was for closure and that there was some plaque i would not code it the angio
hope that help
interested to hear others opinion

[brandyleigh23]

Thank you both so much for your input. Sometimes the docs are very vague in their documentation. I took your advise and did not code for an angio since he was really just searching for the closure and only made a statement regarding the plaque.



Brandy Edmondson CPC