Chronic Total Occlusion of a coronary artery

[Jim Pawloski]

I need a little help.
I have been asked about chronic total occlusion of a coronary artery and the attempt to open the artery. A lot of equipment and time is involved in the attempt to open the artery. I thinking of using the angioplasty charge and adding modifier -52 for reduced services. Also what should the doctor have in his dictation to be able use this coding combination.

Thanks,
Jim Pawloski, CIRCC

 

[theresa.dix@tennova.com]

I need a little help.
I have been asked about chronic total occlusion of a coronary artery and the attempt to open the artery. A lot of equipment and time is involved in the attempt to open the artery. I thinking of using the angioplasty charge and adding modifier -52 for reduced services. Also what should the doctor have in his dictation to be able use this coding combination.

Thanks,
Jim Pawloski, CIRCC

Jim ,
I see this alot. With chronic occlusion sometimes the dr has to abort the procedure(it just didnt work). Modifier 52 for if aborted and patient is stable. Yes this would be the correct way to code this. What needs to be documented is what were they attempting to do? You know the plan was to open it with angioplasty then you can use the angioplasty code with 52 modifier. A cardiology consultant told me once, You typically have to go with what you could do and bill for that only or reduce it down. Use 53 modifier if procedure was stopped because patient became unstable.

 

[Jim Pawloski]

Jim ,
I see this alot. With chronic occlusion sometimes the dr has to abort the procedure(it just didnt work). Modifier 52 for if aborted and patient is stable. Yes this would be the correct way to code this. What needs to be documented is what were they attempting to do? You know the plan was to open it with angioplasty then you can use the angioplasty code with 52 modifier. A cardiology consultant told me once, You typically have to go with what you could do and bill for that only or reduce it down. Use 53 modifier if procedure was stopped because patient became unstable.

Thank you very much for the information.

Jim Pawloski, CIRCC

 

[theresa.dix@tennova.com]

Thank you very much for the information.

Jim Pawloski, CIRCC

Your Welcome!