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  #1  
Old 08-15-2011, 06:00 AM
theresa.dix@ethc.com theresa.dix@ethc.com is offline
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Default thrombectomy coding

Needing some input. 92973 is only to be used for mechanical thrombectomy. If an aspiration thrombectomy is done according to Z health they recommend the unlisted code. Last I knew Z health was waiting for clarification from AMA and ACC on this. Has anyone heard if the clarification came? Some of our physicians are asking and I cannot fine the answer.

Thank you,
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Old 08-15-2011, 08:11 PM
Jim Pawloski Jim Pawloski is offline
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Originally Posted by theresa.dix@ethc.com View Post
Needing some input. 92973 is only to be used for mechanical thrombectomy. If an aspiration thrombectomy is done according to Z health they recommend the unlisted code. Last I knew Z health was waiting for clarification from AMA and ACC on this. Has anyone heard if the clarification came? Some of our physicians are asking and I cannot fine the answer.

Thank you,
Hi Theresa,
I am taking this from Dr.Z's book;
Code 92973 is utilized for removal of thrombus (thrombectomy) from a coronary artery. This may be performed with an Export AP aspiration catheter, Pronto V3, Angiojet or other simular catheter/device. I have billed this code, and have not heard if it wasn't accepted. Has anyone else had any problems?

Thanks,
Jim Pawloski, CIRCC
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  #3  
Old 08-16-2011, 03:56 AM
theresa.dix@ethc.com theresa.dix@ethc.com is offline
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Originally Posted by Jim Pawloski View Post
Hi Theresa,
I am taking this from Dr.Z's book;
Code 92973 is utilized for removal of thrombus (thrombectomy) from a coronary artery. This may be performed with an Export AP aspiration catheter, Pronto V3, Angiojet or other simular catheter/device. I have billed this code, and have not heard if it wasn't accepted. Has anyone else had any problems?

Thanks,
Jim Pawloski, CIRCC
Jim,
Read this article by dr z on thrombectomy coding. You will see what why I am asking.If for some reason you cant open I will send article.

http://www.zhealthpublishing.com/Abo...evel2MenuID=42


Let me know what you think!
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Old 08-16-2011, 02:36 PM
jewlz0879 jewlz0879 is offline
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Quote:
Originally Posted by theresa.dix@ethc.com View Post
Needing some input. 92973 is only to be used for mechanical thrombectomy. If an aspiration thrombectomy is done according to Z health they recommend the unlisted code. Last I knew Z health was waiting for clarification from AMA and ACC on this. Has anyone heard if the clarification came? Some of our physicians are asking and I cannot fine the answer.

Thank you,
This is from Medlearn just in May:

May 30, 2011
Question:
*Previous Question/Answer: When using a thrombectomy catheter during percutaneous cardiac intervention (PCI), can 92973 be assigned when a manual extraction catheter such as the Pronto or Quick-Cat is used?

Answer: Yes, code 92973 can be used regardless of the method of thrombectomy.


Answer:
*Further explanation of above answer: In a previous question regarding the use of an extraction catheter (e.g. for aspiration of clot), MedLearn indicated that code 92973 would be the appropriate code for an aspiration thrombectomy. Recently the American Medical Association (AMA) and the American College of Cardiology (ACC) released new information that revises this answer. In their CPT Reference Guide for Cardiovascular Coding, they state the following:

"Code 92973 is used to report mechanical thrombectomy using an Angiojet or similar catheter that mechanically fragments and removes clots. Other procedures using catheters (e.g. pronto, Fetch) that aspirate thrombus but do not mechanically fragment thrombus are not reportable with codes 92973."
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Old 08-16-2011, 02:38 PM
jewlz0879 jewlz0879 is offline
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Originally Posted by jewlz0879 View Post
This is from Medlearn just in May:

May 30, 2011
Question:
*Previous Question/Answer: When using a thrombectomy catheter during percutaneous cardiac intervention (PCI), can 92973 be assigned when a manual extraction catheter such as the Pronto or Quick-Cat is used?

Answer: Yes, code 92973 can be used regardless of the method of thrombectomy.


Answer:
*Further explanation of above answer: In a previous question regarding the use of an extraction catheter (e.g. for aspiration of clot), MedLearn indicated that code 92973 would be the appropriate code for an aspiration thrombectomy. Recently the American Medical Association (AMA) and the American College of Cardiology (ACC) released new information that revises this answer. In their CPT Reference Guide for Cardiovascular Coding, they state the following:

"Code 92973 is used to report mechanical thrombectomy using an Angiojet or similar catheter that mechanically fragments and removes clots. Other procedures using catheters (e.g. pronto, Fetch) that aspirate thrombus but do not mechanically fragment thrombus are not reportable with codes 92973."
So they really didn't answer the question. Well, AMA and ACC didn't offer the 'correct' code
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Old 08-17-2011, 06:14 AM
Jim Pawloski Jim Pawloski is offline
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Originally Posted by jewlz0879 View Post
So they really didn't answer the question. Well, AMA and ACC didn't offer the 'correct' code
I read the Medlearn answer, and it confused me even more. That's why I still bill for the thrombectomy until someone gives me an answer.

Jim Pawloski, CIRCC
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  #7  
Old 08-17-2011, 07:16 AM
theresa.dix@ethc.com theresa.dix@ethc.com is offline
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Originally Posted by Jim Pawloski View Post
I read the Medlearn answer, and it confused me even more. That's why I still bill for the thrombectomy until someone gives me an answer.

Jim Pawloski, CIRCC
lol yea I understand. I am going to use the unlisted code since Dr Z says he recommends that until he gets more clarification.
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Old 08-17-2011, 01:22 PM
Jim Pawloski Jim Pawloski is offline
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Originally Posted by theresa.dix@ethc.com View Post
lol yea I understand. I am going to use the unlisted code since Dr Z says he recommends that until he gets more clarification.
A lillte more information that may help. After reading this, I am not going to bill for suction thrombectomy until either the AMA or ACC come out with a better explaination.

Description of 92973 in The Coders Desk Reference.


The physician percutaneously removes a blood clot from a native or grafted coronary artery. A double lumen catheter is passed to the area of the clot. A high-pressure saline stream (via a pump) is introduced through a lumen that has multiple jet orifices located at the distal tip. The low pressure zone created by the jets causes the clot to break-up into small pieces and be pushed through the catheter with a force that drive debris from the thrombus through the other lumen(exhaust) and out of the body. The procdure is useful to clear fatty and degenerated arteries and to modify plaques in preparation for more definitive treatment with adjunctive balloon angioplasty or stenting.

CPT Assistant March 2002 pg 10.
Question:
How should I report an angiojet coronary vessel treatment?

AMA Comment:
A new code was added to CPT 2002 for percutaneous thrombectomy procedures performed for the coronary vessels. Code +92973, Percutaneous transluminal coronary thrombectomy (list separately in addition to code for primary procedure), should be used to report the performance of coronary artery thrombectomy specifically by catheter-based angiojet.
Use of an angiojet procedure to clear a blockage in the coronary vessel(s) was preciously reported with the unlisted code 93799. This service/procedure designed is to diagnose or treat or the conditions of intracoronary thrombus in patients with recent MI or acute coronary syndrome, saphenous vein graft thrombus in patients with recent MI or acute coronary syndrome, and acute myocardial infarction with extensive local thrombus formation

Let us know your thoughts on this.
Hey Danny what do you think?

Jim Pawloski, CIRCC
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  #9  
Old 08-18-2011, 09:35 AM
dpeoples dpeoples is offline
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Quote:
Originally Posted by Jim Pawloski View Post
A lillte more information that may help. After reading this, I am not going to bill for suction thrombectomy until either the AMA or ACC come out with a better explaination.

Description of 92973 in The Coders Desk Reference.


The physician percutaneously removes a blood clot from a native or grafted coronary artery. A double lumen catheter is passed to the area of the clot. A high-pressure saline stream (via a pump) is introduced through a lumen that has multiple jet orifices located at the distal tip. The low pressure zone created by the jets causes the clot to break-up into small pieces and be pushed through the catheter with a force that drive debris from the thrombus through the other lumen(exhaust) and out of the body. The procdure is useful to clear fatty and degenerated arteries and to modify plaques in preparation for more definitive treatment with adjunctive balloon angioplasty or stenting.

CPT Assistant March 2002 pg 10.
Question:
How should I report an angiojet coronary vessel treatment?

AMA Comment:
A new code was added to CPT 2002 for percutaneous thrombectomy procedures performed for the coronary vessels. Code +92973, Percutaneous transluminal coronary thrombectomy (list separately in addition to code for primary procedure), should be used to report the performance of coronary artery thrombectomy specifically by catheter-based angiojet.
Use of an angiojet procedure to clear a blockage in the coronary vessel(s) was preciously reported with the unlisted code 93799. This service/procedure designed is to diagnose or treat or the conditions of intracoronary thrombus in patients with recent MI or acute coronary syndrome, saphenous vein graft thrombus in patients with recent MI or acute coronary syndrome, and acute myocardial infarction with extensive local thrombus formation

Let us know your thoughts on this.
Hey Danny what do you think?

Jim Pawloski, CIRCC
I think I have a headache . We have a perfectly good code for this (cpt description does not specify mechanical) and the professional societies (ACC/AMA) have clouded the water. Why did they issue this new guideline? Perhaps they want to develope a new code?
Fortunately for me, all the coronary thrombectomies I see are with an angioget (so far).

stay tuned....
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  #10  
Old 08-18-2011, 11:35 AM
theresa.dix@ethc.com theresa.dix@ethc.com is offline
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Quote:
Originally Posted by dpeoples View Post
I think I have a headache . We have a perfectly good code for this (cpt description does not specify mechanical) and the professional societies (ACC/AMA) have clouded the water. Why did they issue this new guideline? Perhaps they want to develope a new code?
Fortunately for me, all the coronary thrombectomies I see are with an angioget (so far).

stay tuned....

LOL Well I have something from Medtronic that tells angiojet 92973 unlisted fetch and pronto. The water is getting deeper. If you want to see this I can forward it to your emails. If not I understand. lol
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