Wiki Arteriograms & runoff

[dpumford]

Patient had a complex case which we did stent & PTCA's in the Rt leg. A runoff was also done also (75710-26)

Later that day pt was brought back to OR due to absent pulses and worseing ischemia. So again we did a 75710-26.

My question is, would it be incorrect to bill as a 75716-26 and not bill the 75710-26 twice. It is same leg, same day but different session."As I know one of these will get rejected. Each encounter will be on its own claim/episode.

The pt also had PTCA's done during each encounter; so would you code the the S & I (75964) for the 1st ptca done on return due to the fact pt had them done earlier in the day or should we just code 75962-26 then 75964-26 as you normally would do?

Have I confused you yet!

Thanks!

 

[mikereyland]

First, I would not combine anything from separate encounters even if they are on the same day. Code each Sx independently.
Second, I would add the 76 modifier to the codes for the second Sx. If they deny write an appeal explaining the circumstances....If Medicare is the payer you should not have a problem.
Hope this helps.

Michael D. Reyland, CPC, CIRCC
Surgical Specialists of Georgia