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Wiki Atherectomy help

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klthompson

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My provider feels that each of the procedures listed below can all be billed separately. I have tried to explain about bundling, but he does feel that bundling applies to the below. Please review the listed procedure and give me your thoughts of what all can be billed on this case.

1. Insertion of catheter into aorta (36200)
2. Bilateral aorto-iliac-femoral-popliteal angiography/fluoroscopy with radiologic interpretation (75630)
3. Selective catheter placement into Right External Iliac Artery-first order (36246)
4. Selective catheter placement into Right Common Femoral Artery-second order (36246)
5. Selective catheter placement into Right Superficial Femoral Artery-third order (36247)
6. Selective catheter placement into Right Popliteal Artery-fourth order (36247)
7. Endovascular Revascularization of Right External Iliac Artery with transluminal balloon angioplasty/transluminal stent placement (37225)
8. Endovascular Revascularization of Right Superficial Femoral Artery with transluminal balloon angioplasty/Atherectomy (37221)
6. Closure of left common femoral arterial access site using AngioSeal closure device
 
klthompson said:
My provider feels that each of the procedures listed below can all be billed separately. I have tried to explain about bundling, but he does feel that bundling applies to the below. Please review the listed procedure and give me your thoughts of what all can be billed on this case.

1. Insertion of catheter into aorta (36200)
2. Bilateral aorto-iliac-femoral-popliteal angiography/fluoroscopy with radiologic interpretation (75630)
3. Selective catheter placement into Right External Iliac Artery-first order (36246)
4. Selective catheter placement into Right Common Femoral Artery-second order (36246)
5. Selective catheter placement into Right Superficial Femoral Artery-third order (36247)
6. Selective catheter placement into Right Popliteal Artery-fourth order (36247)
7. Endovascular Revascularization of Right External Iliac Artery with transluminal balloon angioplasty/transluminal stent placement (37225)
8. Endovascular Revascularization of Right Superficial Femoral Artery with transluminal balloon angioplasty/Atherectomy (37221)
6. Closure of left common femoral arterial access site using AngioSeal closure device
Click to expand...


According to guidelines for lower extremity arterial stenting, atherectomy and angioplasty, interventions performed in the affected areas include;
1. Vascular access, SELECTIVE CATH device placement,
2. RS&I
3. Embolic protection
4. Closure device placement
5. Completion Angiography.

In this case I would code 37221 (external iliac stent&angioplasty) 37225 (SFA angioplasy/atherectomy), 75630-59 only.

Jim, CPC-P, CIRCC
 
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