I received denial from billing dept that CPT 36245 was denied due to wrong modifier & Medicaid's requesting appropriate Modifier for CPT 36245--this claim was submitted as 36245--Mod 50 for 3 units. I seriously need help on this report. This is my first time coding for Interventional Radiology. This is the 3rd and last attempt as insurance will consider paying this claim being that it was submitted twice already. Someone please advise. Thank you again for your time and consideration. Greatly appreciate it! The report is as followed:
Administrative/medical emergency consent was obtained/signed by trauma team. The patient was brought to the Angio suite from emergency room by trauma team and placed on angio table in supine position. Right groin was prepped and draped in the usual sterile fashion. 1% lidocaine was used as local anesthetic. Access was gained to right common femoral artery using single wall 18 gauge needle. 5 French vascular sheath was placed . Pigtail catheter abdominal aortogram failed to reveal contrast extravasation.
Bilateral lumbar arteries where studied.
5 French catheter was used to access left L2 artery. Diagnostic angiogram of theleft L2 showed acute hemorrhage .Distal branch of the left second lumbar artery was selected using 3 French micro- catheter.Embolization was performed using 4 3x30 mm 0.018 coils with an excellent angiographic result.
5 French catheter was used to access right L2 artery. Diagnostic angiogram of the the right second lumbar showed acute hemorrhage .Distal branch of the right second lumbar was selected using 3 French micro- catheter.Embolization was performed using 4 3x30mm 0.018 coils with an excellent angiographic result.
5 French catheter was used to access left third lumbar artery. Diagnostic angiogram of the left third lumbar showed acute hemorrhage .Distal branch of the left third lumbar was selected using 3 French micro- catheter.Embolization was performed using 3 3x30mm 0.018 coils with an excellent angiographic result.
5 French catheter was used to access left fourth lumbar artery. Diagnostic angiogram of the left fourth lumbar showed acute hemorrhage .Distal branch of the left fourth lumbar was selected using 3 French micro- catheter.Embolization was performed using 3 3x30mm coils with an excellent angiographic result Post-embolization angiogram of fourth left lumbar shows no acute extravasation.
Additional selective angiogram of left common iliac, right common iliac, thoracic aorta and left intercostal arteries shows no evidence of extravasation.
Case was discussed with trauma team. R right groin arterial sheath was connected to a pressure bag an the patient was sent to SICU in satisfactory condition
Impression :
1/ Successful embolization off theleft L2, L3 L4 and R L2 arteries as described above.
2 / No gross evidence of acute arterial extravasation from thoracic aorta or intercostal arteries.
Administrative/medical emergency consent was obtained/signed by trauma team. The patient was brought to the Angio suite from emergency room by trauma team and placed on angio table in supine position. Right groin was prepped and draped in the usual sterile fashion. 1% lidocaine was used as local anesthetic. Access was gained to right common femoral artery using single wall 18 gauge needle. 5 French vascular sheath was placed . Pigtail catheter abdominal aortogram failed to reveal contrast extravasation.
Bilateral lumbar arteries where studied.
5 French catheter was used to access left L2 artery. Diagnostic angiogram of theleft L2 showed acute hemorrhage .Distal branch of the left second lumbar artery was selected using 3 French micro- catheter.Embolization was performed using 4 3x30 mm 0.018 coils with an excellent angiographic result.
5 French catheter was used to access right L2 artery. Diagnostic angiogram of the the right second lumbar showed acute hemorrhage .Distal branch of the right second lumbar was selected using 3 French micro- catheter.Embolization was performed using 4 3x30mm 0.018 coils with an excellent angiographic result.
5 French catheter was used to access left third lumbar artery. Diagnostic angiogram of the left third lumbar showed acute hemorrhage .Distal branch of the left third lumbar was selected using 3 French micro- catheter.Embolization was performed using 3 3x30mm 0.018 coils with an excellent angiographic result.
5 French catheter was used to access left fourth lumbar artery. Diagnostic angiogram of the left fourth lumbar showed acute hemorrhage .Distal branch of the left fourth lumbar was selected using 3 French micro- catheter.Embolization was performed using 3 3x30mm coils with an excellent angiographic result Post-embolization angiogram of fourth left lumbar shows no acute extravasation.
Additional selective angiogram of left common iliac, right common iliac, thoracic aorta and left intercostal arteries shows no evidence of extravasation.
Case was discussed with trauma team. R right groin arterial sheath was connected to a pressure bag an the patient was sent to SICU in satisfactory condition
Impression :
1/ Successful embolization off theleft L2, L3 L4 and R L2 arteries as described above.
2 / No gross evidence of acute arterial extravasation from thoracic aorta or intercostal arteries.