Wiki CPT code 36140

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16
Location
Bentonville, AR
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Hello, I have pasted my Dr.'s report below. He goes to three different access sites to try and perform a heart cath. Pt has severe PVD and he was unable to perform the heart cath. Please let me know if I coded this correctly. My codes are below the report.
Thank you!!!


Procedure attempted: The plan was to perform emergent coronary angiography, LHC, left ventriculography and PCI if indicated and
feasible.
Procedures performed:
1. Right iliac angiogram.
2. Left iliac angiogram.
3. Right subclavian angiogram

Procedure description:
1. Right Common femoral vein access obtained, 5Fr sheath vascular advanced.
2. Right common femoral artery was cannulated, and due to difficulty in advancing the guidewire , an angiogram was performed with
a hand injection of IV contrast, and the procedure was stopped due to total occlusion of the common right iliac artery.
3. Left common femoral artery was cannulated, and due to difficulty in advancing the guidewire, an angiogram was performed with a
hand injection of IV contrast, and the procedure was stopped due to total occlusion of the common left iliac artery.
4. Right brachial artery was cannulated, but due to difficulty in advancing the guidewire , an angiogram was performed with a hand
injection of IV contrast, and the procedure was stopped due to total occlusion of right subclavian artery.
Procedure findings:
1. Severe Peripheral Arterial Disease, with total occlusion of both common iliac arteries and right subclavian artery.
2. The coronary angiogram and LHC could not be performed due to the reasons exposed above.


36140 (Rt com fem artery cath placement)
36140,59 (Lt com fem artery cath placement)
36140,59 (Right brachial artery cath placement)
75716,26 (bilateral low extrem)
75710,26,59 (Unilateral upper extrem. I didn't use the 75774,26 since he didn't select an artery)

Thanks again,
Kim Floyd,CPC
 
Hello, I have pasted my Dr.'s report below. He goes to three different access sites to try and perform a heart cath. Pt has severe PVD and he was unable to perform the heart cath. Please let me know if I coded this correctly. My codes are below the report.
Thank you!!!


Procedure attempted: The plan was to perform emergent coronary angiography, LHC, left ventriculography and PCI if indicated and
feasible.
Procedures performed:
1. Right iliac angiogram.
2. Left iliac angiogram.
3. Right subclavian angiogram

Procedure description:
1. Right Common femoral vein access obtained, 5Fr sheath vascular advanced.
2. Right common femoral artery was cannulated, and due to difficulty in advancing the guidewire , an angiogram was performed with
a hand injection of IV contrast, and the procedure was stopped due to total occlusion of the common right iliac artery.
3. Left common femoral artery was cannulated, and due to difficulty in advancing the guidewire, an angiogram was performed with a
hand injection of IV contrast, and the procedure was stopped due to total occlusion of the common left iliac artery.
4. Right brachial artery was cannulated, but due to difficulty in advancing the guidewire , an angiogram was performed with a hand
injection of IV contrast, and the procedure was stopped due to total occlusion of right subclavian artery.
Procedure findings:
1. Severe Peripheral Arterial Disease, with total occlusion of both common iliac arteries and right subclavian artery.
2. The coronary angiogram and LHC could not be performed due to the reasons exposed above.


36140 (Rt com fem artery cath placement)
36140,59 (Lt com fem artery cath placement)
36140,59 (Right brachial artery cath placement)
75716,26 (bilateral low extrem)
75710,26,59 (Unilateral upper extrem. I didn't use the 75774,26 since he didn't select an artery)

Thanks again,
Kim Floyd,CPC

Your codes look ok with one exception. I would use 36120 for the brachial artery access unless it was placed antegrade. The modifiers might depend upon the payor's preference. (76 instead of 59 for the catheter placements).

HTH :)
 
Question sorry NEW to this site
How would I bill this?

  • Ultrasound-guided access into the leftt common femoral artery with permanent recording and reporting
  • Atherectomy, balloon angioplasty, and stent placement within the right superficial femoral and popliteal arteries
  • Atherectomy and balloon angioplasty within the right anterior tibial artery
  • Intravascular ultrasound of the left common femoral, superficial femoral, popliteal, and anterior tibial arteries
  • Right lower extremity angiogram
Local anesthesia with 1% lidocaine was administered at the access site. Moderate sedation (conscious sedation) was administered by a Registered Nurse. Total intra-service sedation time (minutes): 85 minutes.

What I have is :

37227 RT
37229 RT / 51
37252 RT
36140 59
37253 RT / 59
75710 26 / 59
99152 x 1
76937 26 / 59
99153 x 4
G9500

Unsure if modifier usage is correct. Like on 37229 would I use 51? Like on 36140 do I need to use modifier LT? Am I missing anything?
 
Additional question to top question. So like for this here.

Selective catheterization of the medial descending genicular artery with angiography and embolization
Selective catheterization of the superior medial genicular artery with angiography and embolization
Selective catheterization of the inferior medial genicular artery with angiography and embolization
Selective catheterization of the superior lateral genicular artery with angiography and embolization
Selective catheterization of the inferior lateral genicular artery with angiography
Selective catheterization of the anterior tibial recurrent genicular artery with angiography and embolization




How many times can I bill cpt code 36140?
 
Question sorry NEW to this site
How would I bill this?

  • Ultrasound-guided access into the leftt common femoral artery with permanent recording and reporting
  • Atherectomy, balloon angioplasty, and stent placement within the right superficial femoral and popliteal arteries
  • Atherectomy and balloon angioplasty within the right anterior tibial artery
  • Intravascular ultrasound of the left common femoral, superficial femoral, popliteal, and anterior tibial arteries
  • Right lower extremity angiogram
Local anesthesia with 1% lidocaine was administered at the access site. Moderate sedation (conscious sedation) was administered by a Registered Nurse. Total intra-service sedation time (minutes): 85 minutes.

What I have is :

37227 RT
37229 RT / 51
37252 RT
36140 59
37253 RT / 59
75710 26 / 59
99152 x 1
76937 26 / 59
99153 x 4
G9500

Unsure if modifier usage is correct. Like on 37229 would I use 51? Like on 36140 do I need to use modifier LT? Am I missing anything?
I would not report the code 36140 for that would be bundled in the atherectomy codes. no modifier needed for code 37253 for this is an add on code and they do not require modifier.
 
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