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    Question Intervention to both native and graft SFA

    Hello! A physician performed atherectomy to the vein graft of the SFA as well as balloon of the native SFA. I lean towards just coding 37225 as it's all the same territory, but I wanted to see if anyone knew of any documentation that supports coding the graft and native separately, like in the...
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    Question CCC Exam

    I missed my anatomical charts when I took it. Good luck to you!
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    Billing Proctored Cases

    Dr. A. is proctoring Dr. K. in abdominal aortic endografts. Based on the dictation, it looks like Dr. K. was the primary operator, but Dr. A was also listed. Would a modifier -62 be the most appropriate in this case, or does the fact that it's a proctored case change things? Thank you! Edit...
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    I'm stuck on this

    Is that the entirety of the report? Where are the catheter placements?
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    Incomplete Ablation

    That was the entirety of the procedure documentation, unfortunately. I can see how 93602 with a -52 would be appropriate. Thank you so much!
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    Incomplete Ablation

    Some help would be greatly appreciated. I'm not sure what I could bill here. :confused: The access? "Patient was brought back to the EP lab and after informed consent was verified patient was placed under anesthesia. After venous access was obtained a sheath was placed and a Blazer ablation...
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    Coding help with my nemisis Peripheral coding

    37226 Previous angiography is mentioned, so any angiography performed would be road mapping, unless there was something new with the patient. The code includes access and catheter placement, but you might be able to fight for 36140.
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    Aborted Afib Ablation

    That's the direction I'm leaning, but I'm not certain the dictation supports a full EP study. Thanks!
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    Aborted Afib Ablation

    I could use some help on what would be proper to charge, please. Can I even charge 93656-53 if the physician didn't begin ablating? History: Patient with atrial fibrillation on Amiodarone and Multaq who presents for a PVI Pre-Op Diagnosis: Atrial fibrillatio Post-Op Diagnosis: Same...
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    EP Device Clinic

    Hello! Our office has some differences of opinions regarding charges for our ICD/PPM clinic, and I'd value some input. According to the Medcare fee schedule, the technical component of the device checks require direct supervision. Our EP is not always in the office during the device clinic...
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    ICD Lead Revision/Swap

    Hello! I'm stuck on this report and could use some help, please. Patient is a 54 year old male with a history of symptomatic sinus node dysfunction s/p permanent pacemaker in 2007 and ischemic cardiomyopathy s/p upgrade to ICD in 2009. His device was recently interrogated in office after he...
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    Denials on Stents with BCBS

    A specific employer plan in Texas just gave me the same argument. She told me they'd only pay for one a day, and scoffed when I asked for that in writing. She suggested I call the AMA for coding advice. Do you think reporting this to SCAI would help at all? Thanks! Leah
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    Angioplasty to the plantar arch

    I'm wondering if anyone has anything more specific, or if I should just code this as 37228 and 37232. Should the foot be considered part of the tibial territory? "...the posterior tibial artery is diffusely diseased and the plantar arch is diffusely diseased. The andterior tibial artery...
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    Hybrid Coronary Revascularization

    One of our physicians is interested in performing the PCI portion of the hybrid revascularization. I'm trying to determine if it would be charged differently than a normal PCI, as he'd be working in tandem with a surgeon. Any help would be appreciated! Leah
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    2013 fee schedule Medicare

    I called Novitas this morning regarding the missing codes, and the person referred me to this article: She also said that it should (hopefully) be addressed in the quarterly update.
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    2013 fee schedule Medicare

    Then it's contagious I was trying to look up the new codes for pricing info and ran into same problem. The CMS fee schedule tool doesn't have 2013 yet, and I can't find any mention of the missing codes on Novitas's website. Leah
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    Yes, we always end up appealing. In the narrative, I add "Impella 2.0, crosswalk to 33975" per the instructions from Abiomed. We have not had much luck with the removals. Your mileage may vary.
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    Transcatheter Paravalvular Leak Closure

    I do not have any dictation to share, as my physician wants me to research the billing and reimbursement prior to attempting this procedure. He wants to close defects in either the mitral or aortic valve using one of the Amplatzer devices. I'm leaning towards 33999 with a crosswalk to 93580...
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    Attempt at rt popliteal access

    Hello! I'd appreciate another set of eyes and opinions here. In this case, I don't think there is anything that I can charge. The patient had a previous angiogram last month. Indications: A 58-year-old diabetic smoker with bilateral SFA occlusions. She has a small caliber but patent popliteal...
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    Electronic Charge Submission

    Our practice wants to investigate methods for the physicians to submit hospital charges to the billing department electronically. Some of our newer physicians state they did such things during their fellowships but can not remember the names of the programs. Does anyone have any experience...
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    Impella 2.5

    The documentation we received from Abiomed gave 33975 for insertion and 33977 for removal. We don't have problems getting 33975 paid, but we have a lot of problems with 33977. Your mileage may vary.
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    Venous Intervention

    Perfect! After reading the descriptions it's starting to make a lot more sense. Thank you so much! Leah
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    Venous Intervention

    This is the first time one of our doctors has done a venous intervention, and I would appreciate any help that could be provided. Arteries I'm comfortable with, but veins? Not so much. Thank you in advance! The codes that I have found thus far are 35476, 75978, 37187, 36005, 75820, and 36010...
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    Impella 2.5 Circulatory Support System - Any experience with this?

    We've been successfully billing 33975-52 for an insertion. However, we can not get the removal (33977-52) paid by any carrier. The codes were provided to our clinic by Abiomed, and they recommended using the -52 modifier. Thanks! Leah, CPC-A
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    Atrial Septal Defect Closure with Transseptal Puncture

    Right, I read that I could not code that cath along with it. I was trying to determine if there was an appropriate way to code the transseptal puncture. Apologies if it was phrased poorly. Thank you!
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    Atrial Septal Defect Closure with Transseptal Puncture

    Hello, One of our doctors performed a purcutaneous transcath. closure (93580) with ICE (93662). However, he also performed a transseptal puncture. He wanted to use 93533, which is not allowed. Any assistance on properly coding this would be appreciated! It was felt that the tunnel was long...