Bilateral Carotid Angio

amym

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I am not sure if the physician provided enough documentation to bill this but here is the reprot:

Procedure Performed: Arch Aortography, Bilateral Internal Carotid Angio

Summary
Arch Vessels: Left Internal Carotid: There was a 60% stenosis
Right Internal Carotid: There was a 85% stenosis. The lesion was irregularly contoured and calcified.

Aorta: Aortic arch: Normal. The segment was type A.

Procedure:
1. Right femoral artery access. The puncture site was infiltrated with local anesthetic. The vessel was accessed using the modifier Seldinger technique.
2. Arch aortography. A catheter was placed and contrast was injected.
3. Bilateral Internal Carotid Angio.

No complications.

Please help!
 
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If you can show that he "parked" in the carotid wouldn't you use 36216? You wouldn't use 36200 if you are to code the furthest he went in the vessels, correct? I would think because he states Internal Carotid, it would be 36216 and 75650 for the arch, and 75671 (cerebral is internal) for the bilateral carotid. Thanks!
 

Cyndi113

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From what I see on the report, the farthest the cath went was the arch. 93567 is an add on code and cannot be billed with 75671. So, 36200 and 75671 and 75650. Sorry
 

donnajrichmond

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I am not sure if the physician provided enough documentation to bill this but here is the reprot:

Procedure Performed: Arch Aortography, Bilateral Internal Carotid Angio

Summary
Arch Vessels: Left Internal Carotid: There was a 60% stenosis
Right Internal Carotid: There was a 85% stenosis. The lesion was irregularly contoured and calcified.

Aorta: Aortic arch: Normal. The segment was type A.

Procedure:
1. Right femoral artery access. The puncture site was infiltrated with local anesthetic. The vessel was accessed using the modifier Seldinger technique.
2. Arch aortography. A catheter was placed and contrast was injected.
3. Bilateral Internal Carotid Angio.

No complications.

Please help!

This needs to go back to the doctor.
Did he select either of the carotids? If so, common or internal?
Internal carotid is partly cervical, partly cerebral, and he doesn't say here what part/s he imaged, so you don't know whether or not to code 75671 or 76580 or both.
 
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I am confused, you mentioned 93567? I think if you can ask the doctor to amend report to reflect going to the carotid it would be worth while for him and RVU values! I agree, report is vague, ask him to confirm, I just had one where my doc needed to do an addendum and I was able to bill the carotid placement.
 
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