Wiki DEB-TACE with variant anatomy

[Aliciawashere]

I am reviewing a case that a co-worker submitted and we have different codes selected. Please, let me know what you would have coded this.


We coded 36247-59, 36247, 36248, 75726-59 x2, 75774-59 x4, 37243. but I feel like we should only have 75774-59 x3.

I would be grateful for any feedback!

TIA,
Alicia E. CPC, CIRCC

 

[Jim Pawloski]

I would code 37243 for embolization, 36246-59 and 75726 for Inferior Phrenic artery, 36247, 75726 and 75774 for left hepatic artery, 36247-59, 75726 and 75774 for segment 8 of the replaced rt hepatic.

HTH,
Jim Pawloski, CIRCC

 

[Aliciawashere]

Interesting! Those are my original codes, but after reading it a million times, I started talking myself in to this:

If he did not reform the catheter in the aorta to select the Inferior Phrenic, then it must be a branch off the celiac artery in this patient?
I am fairly new to IR coding and the coder who coded this originally had 23 years experience, so I started to talk myself out of what my gut was telling me.
Unfortunately, we are a teaching facility and that Fellow has since left our department, therefore I am not able to query the physician. The previous coder has also left so I cannot ask if she did query him before selecting her codes.

Thank you so much for your input!

Alicia E. CPC, CIRCC

 

[Jim Pawloski]

Phrenic artery is off the aorta, above the celiac artery. A SOS catheter is a smaller version of a Simmons catheter, and both have to be reformed in the aorta. The doctor may not always saw that the catheter was reformed.
Thanks,
Jim