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  1. Misty Dawn

    reporting drug wastage to Medicaid

    Many of the Medicaid health plans do not have a specific policy regarding reporting drug wastage on claims. Would it then default to CMS policy if they do not have one in place? Is it ok to report both the amount given and drug wastage on one line to Medicaid health plans? CMS states that it...
  2. Misty Dawn

    CO-97 Denials

    Usually CO-97 is the code is bundled into another code being billed the same day by your group. Is there another code that is being billed on the same day as your denied coded? Can you tell me the codes are being billed together on same day as the ultrasound code?
  3. Misty Dawn

    Transespohogeal Echo Interpretation

    CPT 93315 and 93317 are only used for Diagnostic study. What you are describing is for monitoring during procedure; this is coded with either CPT 93355 or CPT 93318 regardless of congential or non-congential. Below link provides some more indepth description of when each code should be used...
  4. Misty Dawn

    Silly questions about EKG's

    Confirmed ekg means the doctor confirmed the diagnosis and signed his/her interp. I’m not sure if the provider needs to sign the tracing as long as the interp is signed but I’m not 100% sure on this question. Yes the interp can be documented in progress note.
  5. Misty Dawn

    Clinical Trial ID# 33340

    CPT 33340  Primary ICD-10 diagnosis code (one of the following): o I48.0- Paroxymal atrial fibrillation o I48.1- Persistent atrial fibrillation o I48.2- Chronic atrial fibrillation o I48.91- Unspecified atrial fibrillation  Place of service code: 21 (inpatient hospital)  Secondary diagnosis...
  6. Misty Dawn

    Cardiology/Cardiothoracic/Vascular surgery coder

    Misty Dawn Sebert CPC, CCC, CCVTC 509-435-6585 sebertconsulting@gmail.com https://www.linkedin.com/in/mistysebertcardiologycoder/ Open to FT, PT or Contract PositionCertified Cardiology and Cardio-thoracic coder with 8+ years of experience specialized in Cardiology coding...
  7. Misty Dawn

    Denials Vascular Procedure

    Yes it is denied because 75630 and 75716 can not be coded together and there is a CCI edit. 75630 is for single cath placement in the aorta with extremity run off. 75625 – Aortography, abdominal, by serialography, radiological supervision and interpretation 75630 – Aortography, abdominal...
  8. Misty Dawn

    pacemaker lead extraction and explantation of generator

    Depends on the type of system the pacemaker lead or leads are removed from. 33234 is used when a pacemaker lead is removed from a SINGLE lead system (atrial or ventricular) and 33235 is used when a single or multiple leads are removed from a DUAL lead system . CPT 33234 and 33235 do not included...
  9. Misty Dawn

    Denials Vascular Procedure

    75630 basically includes 75710 or 75716. 75630 is used to describe a SINGLE cath placement in the arota with extremity run-off. See below link for some case examples: http://evtoday.com/2011/06/case-examples-for-lower-extremity-coding?center=123...
  10. Misty Dawn

    Internal Mammary with LHC

    If doctor is checking the IMA for potiental CABG then use CPT 93459 (Coronaries + LHC + Native/Bypass graft). This is included in the work of 93459 to determine the viability of the IMA as a bypass graft. Codapedia has good article on this.
  11. Misty Dawn

    Denials Vascular Procedure

    Without seeing the report it is difficult to say what codes are correct or not. However I can tell you a couple things I do see questionable just by looking at the codes. 75630 and 75716 would never be coded together. Need to review where the cath placements where for the angio and correct...
  12. Misty Dawn

    EVAR for pseudoaneurysm in aortofemoral vein graft

    37236 can be used in lower extremity unless treating occlusive "(except lower extremity artery(s) for occlusive disease..." cpt 2017
  13. Misty Dawn

    EVAR for pseudoaneurysm in aortofemoral vein graft

    I thought 37226 was for treating stenosis and was not used for aneurysms?
  14. Misty Dawn

    TAVR Assist Surgeon issues

    These can only be coded with the 62 modifier. 80 modifier is not allowed by medicare on these procedures. https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/downloads/R2628CP.pdf...
  15. Misty Dawn

    EVAR performed in Rt aortofemoral graft

    So this is open cpt code 35141 for aorto-femoral bypass aneurysm repair so maybe 35141 instead of 37236?? thoughts?
  16. Misty Dawn

    Is the Q0 modifier required for OP Medicaid Patient getting an AICD?

    I have the same question. Did you ever find the answer? Thanks
  17. Misty Dawn

    Multiple, dual, co-, and counter signatures.

    Multiple, dual, co-, and counter signatures feature in the EHRs.. Is anyone else struggling with trying to figure out who did what when the rounding notes are signed multiple providers? Especially struggling with this for multi-dis-plenary groups. If you have what steps are implementing...
  18. Misty Dawn

    93455/92937 vs 93454/92920

    No intervention was done so no 92937 or 92920. Provider poked at the blockage a little could not pass; I would not code anything for that. CPT 93455 is all I would code for here.
  19. Misty Dawn

    EVAR performed in Rt aortofemoral graft

    I am so lost on what to code for this report. I am thinking 37236? Please help! Selective right aorto-femoral graft angiogram Endovascular graft placement within the right aortofemoral CryoVein graft - Viabahn 13.0 mm x 10 cm self-expanding covered graft Operators: Dr. A Dr. B...
  20. Misty Dawn

    EVAR for pseudoaneurysm in aortofemoral vein graft

    I am so lost on what to code for this report. I am thinking 37236? Please help! Selective right aorto-femoral graft angiogram Endovascular graft placement within the right aortofemoral CryoVein graft - Viabahn 13.0 mm x 10 cm self-expanding covered graft Operators: Dr. A Dr. B...
  21. Misty Dawn

    Coding for His bundle lead placement

    Unless the lead is in the LV it would not be appropriate to use the LV codes. Most likely the lead is in the RV or maybe the RA. Query the provider/medical records to confirm where the lead is.
  22. Misty Dawn

    Echocardiogram Limited vs Complete

    Diagnostic studies can be performed/coded as many times as medically necessary. It is always good idea to be familiar with your specific insurance guidelines but I have never seeing where there was a limit on how often a complete echo can be performed as long as medically necessity is...
  23. Misty Dawn

    Certified Cardiology and Cardio-thoracic coder with 8 years of experience.

    Certified Cardiology and Cardio-thoracic coder with 8 years of experience. Specialized and knowledgeable in coding:• ICD-10-CM •Diagnostic Cardiology •Interventional Cardiology •Electrophysiology Cardiology •Pediatric Cardiology •Vascular and Thoracic Cardiology procedure coding. Pro-fee...
  24. Misty Dawn

    Cooling catheter-Does any one

    It is from 2013. Is there specific coding question you are looking for?
  25. Misty Dawn

    New guidelines for 10-1-16, HTN-CHF-CKD

    I am not sure I completely understand what your are asking above but for 2017 the requirement for the doctor to dictate a casual relation between hypertension with heart disease has been replaced with new instructions. For 2017 the rule is to report the heart condition separately from the...
  26. Misty Dawn

    Cardiology/Cardiothracic certified coder looking for remote assignments

    Certified Cardiology and Cardiothoracic coder with 8 years of experience. Specialized and knowledgeable in coding:• ICD-10-CM •Diagnostic Cardiology •Interventional Cardiology •Electrophysiology Cardiology •Pediatric Cardiology •Vascular and Thoracic Cardiology procedure coding. Pro-fee &...
  27. Misty Dawn

    heart cath/ptca with 15 cardioversions HELP!

    Yes you can code for the balloon pump-33967 for the cardiogenic shock.
  28. Misty Dawn

    Upgrade to CRT-P

    CPT 33229 is used only if the generator is replaced and no new leads. This would not be correct for the above case because a new RA lead was also placed. CPT 33225 is for LV lead insertion only-from the sound of above the LV placed prior to or by another provider and would not be coded here...
  29. Misty Dawn

    heart cath/ptca with 15 cardioversions HELP!

    I agree with L. Mark Kozu response ..Mi/92941 is correct Misty Sebert CPC, CCC, CCVTC
  30. Misty Dawn

    Tighting pulm band during bi directional glenn

    Can CPT 33690 be used for tightening of existing pulm band? or unlisted? Either as only procedure performed and/or with a bi directional glenn? Thanks for you help, I can't find any references on this!
  31. Misty Dawn

    Transcatheter tricuspid valve replacement

    Hi, Could you post the report, or a little section of the report how the procedure was performed please? or at least the name of device used. I would say 33999 unlisted code but would have to had prior auth.... I think this is still investigational but not sure. Would really like a little...
  32. Misty Dawn

    codes

    Yes it is normal to see the Doctor take the shot from the subclavin to look at IMA for potential CABG. Little hard to tell without the report though. Thanks,
  33. Misty Dawn

    codes

    If doctor is checking the IMA for potiental CABG then use CPT 93459 (Coronaries + LHC + Native/Bypass graft). This is included in the work of 93459 to determine the viability of the IMA as a bypass graft. Codapedia has good article on this.
  34. Misty Dawn

    Pacemaker Checks with Modifier TC/26 correct coding help please

    Hi, You can not bill for the technical service of a remote or in-person device evaluation if the device representative performs the check. In order to bill technical service, physicians must either perform the procedure or supervise a Qualified Staff. Device Reps are not "Qualified Staff"...
  35. Misty Dawn

    Charge for intracopertive TEE during AVR (for facility)

    Sorry Chlrtrep!! you did say "open" right in the first line and I blew right over it! For open procedures when they do TEE before/during/and,or after I use CPT 93318. CPT 93318 is for TEE monitoring to asses function assist with decisions performed intraoperatively (eg, open cardiac...
  36. Misty Dawn

    Cardioversion with EP study x two

    but something else to think about before you bill the cardioversion is if the doctor put the patient in VT during the ep study then you can not bill for cardioversion. If the patient arrived in VT and doctor had to perform cardioversion thru the ICD in order to do the EP Study then you can bill it.
  37. Misty Dawn

    Charge for intracopertive TEE during AVR (for facility)

    Look at CPT 93355 for inter-operative TEE during Valve surgery. There are some special guidelines on who can use the code. HTH, Misty Sebert CPC, CCC, CCVTC
  38. Misty Dawn

    Cardioversion with EP study x two

    Use the unlisted code 93799 for the cardioversion used thru the ICD device and appropriate code for the EP study if the documentation supports EP study. HTH, Misty Sebert CPC, CCC, CCVTC
  39. Misty Dawn

    should i bill cardioversion-92960

    No modifier for this. The procedure was complete. You are coding for the work done not the success of procedure. Misty Sebert CPC, CCC, CCVTC
  40. Misty Dawn

    CPC looking for remote coder position

    Check your private message, I sent you some info.
  41. Misty Dawn

    Cardiology/Cardiothracic certified coder looking for remote assignments

    I am a certified Physician, Cardiology and Cardiothoracic coder with 8+ years of experience in coding and consulting for cardiology practices throughout the United States. I am available for new remote assignments. Please find attached my resume or view my information on Link in at...
  42. Misty Dawn

    bilateral Nephrostogram and bilateral nephrostomy tube exchange

    Need a second opinion on my codes for this procedure please! I am not sure if I am coding this correctly. Thank you, Thank you for any feedback! A bilateral Nephrostogram and bilateral nephrostomy tube exchange was performed. Medical necessity supports coding the diagnostic procedure...
  43. Misty Dawn

    Coding help

    I don't have a reference for you besides the CPT and Zhealth but can tell by the common placements that the "outside the endoprothesis target zone" is referring to balloon angioplasty and stent not the IVUS. I do code for the IVUS. Other interventional procedures performed at the time of...
  44. Misty Dawn

    CPT code for Pocket creating during pacemaker generator placement

    Did Doctor B create the pocket and place the pacemaker after Dr A did lead placement? Usually when I see report like this Dr. A lead(s) placement only see CPT 33216-33218 or 33202-33203 if epicardial lead placement. Then for Dr. B creates pocket, places generator in pocket see CPT...
  45. Misty Dawn

    pacemaker revision

    I use the unlisted 17999 when the only the pocket was expanded. I would not code this as a complex repair. HTH, Misty Sebert CPC, CCC, CCVTC
  46. Misty Dawn

    2 Access points in an LHC with Grafts

    I agree with Chirtrep. I normally do not code for the abandoned access separately with the HTC codes. There would have to be an occlusion/stenosis with multiple attempts/caths, really strong documentation supporting the amount of work and medical nec to code separately. Misty Sebert CPC...
  47. Misty Dawn

    Endovascular repair of aortoiliac occlusive disease

    can you post the report? If treating aortoilliac stenosis you would use 37221. If treating anuerysm in the illiac you would use 34900. Was the aorta addressed graft? that code change coding to. If you can add a little more detail I can assist your better. Thanks, Misty Sebert CPC, CCC...
  48. Misty Dawn

    Cardioversion via his implantable defibrillator

    I use the unlisted code 93799. There is no CPT code for cardioversion delivered through a device. Misty Sebert CPC, CCC, CCVTC https://www.linkedin.com/in/mistysebertcardiologycoder
  49. Misty Dawn

    Pm pocket revision

    There is not code for pocket revision only relocation. I use 17999 for revision. Misty Sebert CPC, CCC, CCVTC https://www.linkedin.com/in/mistysebertcardiologycoder
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