Wiki Atricare device

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rejenia

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I'm interesting in knowing how this procedure is being billed Dr. is doing a pulmonary vein isolation using the Atricare device and atrial clip placement on the left atrial appendage. I've read when done with the CABG use 22 modifier. I know about the modified maze procedure 33254-33259 which the left atrial is apart of that but Dr. is not stating that is what he is doing.
Is there anyone billing for this.

Dr. verbiage is: the right superior and inferior pulmonary veins were dissected out and encircled. The Atricare ablation device was then placed around the right-sided pulmonary veins and they were ablated 3 times following this the left side was similarly treated. Next the aorta was cross clamped, and the heart was arrested with antegrade followed by retrograde cardioplegia. then the left atrial appendage was measured. A 40-mm atrial clip was then obtained and placed over the base of the left atrial appendage. A CABG was done also with the procedure

How is this being bill with 22 modifier or as a maze ( modified) etc.

Thanks
 
I believe you have both a limited maze (33257) with a LAAS (left atrial appendage stapling) with your CABG. I use to bill the LAAS as 33999 (and you know what that pays! LOL).

I would bill your CABG with the 22 modifier and the limited MAZE (33257) but also send the operative report

Hope this helps!
D. Vance, CPC, CCVTC
 
Unfortunately, the atrial appendage procedure is not separately billable as your physician did a limited maze procedure. Hence his verbiage states that the right and left pulmonary veins were ablated 3 times on each side. Per STS, anytime an atrial appendage procedure is performed with mitral valve or Maze it is inclusive and not billable. Below is the excerpt from an STS conference. So the answer to your question is no, modifier 22 would not be appropriate you would just bill the CABG and the limited maze 33257.

"*Atrial appendage ligation, plication, stapling, or clip is included in mitral valve and Maze procedures and should not be reported separately when performed in the same session. "-

excerpt from STS 2015 coding conference.

Hope this helps even though I know it is alittle late!

Christina McFann, CPC, CIRCC, CCVTC
 
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