Jim Pawloski
True Blue
I have a question on a patient who was found to have an occlusion of the left internal carotid. Unfortunately, it covered over a week with four date of services. So here is the "Readers Digest" version.
Day one- Left Vertebral angio, Rt Internal Angio where contrast is seen crossing from the right side to the left side of the internal carotid artery. Lt Common carotid injection shows slow to no flow of the internal carotid artery. Procedure complete.
Day two- Bilateral Internal angio. performed. Balloon Occlusion Test in Right Carotid performed Lt Common Carotid injected. Micro-catheter passed occlusion into M1 segment of carotid artery. Imaging of M1 segment performed. Wingspan stent placed in supraclinoid portion of lt internal carotid artery,
Day three- Right vertebral and bilateral Internal arteries imaged. Angioplasty of Lt Internal Carotid performed.
Day four - Bilateral internal carotids and Lt vertebral catheterized and imaged. 3-d imaging
of lt internal carotid performed.
This is what I billed:
Day 1
36224-rt
36223-lt
36226-lt
Day 2
61623-rt
61635-lt
36228-lt
Day 3
36226-rt
61630-lt
36228-lt
Day 4
36224-rt
36224-lt
36226-lt
76377
Each procedure was performed 5 days apart.
Should a diagnositc angio be billed in determine if there was any change in flow from the right cerebral to the left cerebral?
Thanks,
Jim Pawloski, CIRCC
Day one- Left Vertebral angio, Rt Internal Angio where contrast is seen crossing from the right side to the left side of the internal carotid artery. Lt Common carotid injection shows slow to no flow of the internal carotid artery. Procedure complete.
Day two- Bilateral Internal angio. performed. Balloon Occlusion Test in Right Carotid performed Lt Common Carotid injected. Micro-catheter passed occlusion into M1 segment of carotid artery. Imaging of M1 segment performed. Wingspan stent placed in supraclinoid portion of lt internal carotid artery,
Day three- Right vertebral and bilateral Internal arteries imaged. Angioplasty of Lt Internal Carotid performed.
Day four - Bilateral internal carotids and Lt vertebral catheterized and imaged. 3-d imaging
of lt internal carotid performed.
This is what I billed:
Day 1
36224-rt
36223-lt
36226-lt
Day 2
61623-rt
61635-lt
36228-lt
Day 3
36226-rt
61630-lt
36228-lt
Day 4
36224-rt
36224-lt
36226-lt
76377
Each procedure was performed 5 days apart.
Should a diagnositc angio be billed in determine if there was any change in flow from the right cerebral to the left cerebral?
Thanks,
Jim Pawloski, CIRCC