Attempted Venous Ablation of vaicose veins

dpumford

Expert
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Hi!:( I am hoping that some one can give me some in-put on this!
Our physician is doing a venous ablation of varicose veins (36478) in office. He his unable to access the vein and attempts this mutliple times. He then does access the vein but unable to thread the guidewire so the procedure is terminated. This is all done under ultrasound. We have had several opinions on how to code this with one being 36478-53. I am not comfortable with this and am hoping that someone can HELP with this. :)
Thank you!!
 

barbcpc

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Hi,

I wouldn't use 36478-53 due to the reimbursement is high and the dr. wasn't able to do any of the ablation. Take a look at 36000 and 36012. If he was able to actually place the catheter, 36012 may apply. If not, I'd use 36000. I'd also use whichever imaging guidance CPT that applies (ultrasound, CT, fluoroscopic).

Hope this helps.
 

krmichae

Contributor
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Topeka, KS
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I would use the 36478-53. The physician spent his time and still has the cost of the supplies and staffing that was needed. The supplies for these procedures are a large part of the reimbursement.
 

kgarner

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New Kensington, PA
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Endovenous ablation laser veins

I actually just had the same question asked by my physician. Only difference,
he didn't get the catheter nor the wire in after multiple attempts. Since the kits run between 250-300 dollars he doesn't want to be out that money.

So would the 36000 still apply in my case plus whatever imaging was used. I don't agree with the 36478-53. They say you should bill for what closely relates to the work performed.

I'm new to this procedure so I'm lost.

TIA

kgarner
Specialty coder
 
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