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Wiki CABG W/O by pass

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coop22

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Is there a code for a CABG w/o bypass. I keep coming across 33503 but that looks like it is for a congenital issue. And This was for Vein and Artery. So would it need two codes?

Would there be a code for CABG w/o bypass for CAD the procedure we coded ended up being 33533 , 33518 but the surgeon ended up doing it with out the by pass machine.
 
Hi! At this time there is no code for doing a Cabg on a pt that is not on Bypass.

I have heard some say add mod 52 but have not seen this in writing. It takes a talent to do a Cabg on a pt who is not on Bypass and they should not have their reimbursment reduced..Just saying. :)

DP
 
Thank you(as if I am the one doing such, just the coder over here :D) I was reading Mod 22 if documentation was shown. But I am not sure if anyone has done that.
 
The 22 is for the increased time it takes that the standard procedure hmm I may have just answerd my own question.
 
I believe this question was asked a couple of years ago at an STS workshop I attended. They stated that a 22 mod can be used on off-pump CABG bypasses. I've been using it for quite a while now, I just make sure to send the op note with the billing.

HTH
Dorinda
 
Thank you for responding.
Now with the 22 modifier we are looking into using it. Does that get paid just by providing the op report? Because our practice does them often off bypass.
And do you get it paid at an increased rate?
 
I'm strictly the coder but we really don't do them that often, only on CABG x1. From looking into the A/R accts on a few patients, it doesn't look at though our Medicare-Ohio recognizes it. :( . If I get a chance I'll look into other payors to see what they do.
 
Have you used that modifier on any other code? I wonder if they just did not think the documentation was enough for the 22 modifier. I have been looking into the 22 and seeing they it only gets paid to 3-5% of the time. But if your saying its not recognized at all by medicare in your state I should look into mine. This is very helpful. Thank you
 
This question came up back in 2012 about using Modifier 22 and I emailed Julie Painter at STS for clarification and received the following reply:

"It is not a given that the -22 modifier should be appended to the off-pump CABG cases. It would be determined on a case by case basis considering the work differential compared to the existing code. The entire global should be considered too, so maybe it takes a little longer to perform the procedure off-pump, but it might mean one less hospital or office visit during the global period.
There is no given formula or criteria for when to use the -22 modifier, but a general consideration is that the case should represent 20% - 30% more work then the procedure to report the -22 modifier, which will probably not typically occur in the off-pump versus on-pump CABG codes. Also, the -22 modifier takes into account the total work effort, so not only a time differential, but also increased intensity, technical difficulty of procedure, severity of the patient's condition, physical and mental effort required, risk to patient and physician. The op note should reflect the increased work involved and some payers require a separate note supporting the increased work effort.

So bottom line, there may be cases where the -22 modifier is warranted for an off-pump CABG case, but it should not be used on all cases."
 
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