Wiki Fibrin sheath disruption

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kvo

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Oldsmar, FL
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In following the latest guidelines for fibrin sheath disruption through the same access we are billing 37799 with a descriptor as required in box 19 of the cms1500. Even with the descriptor we are still receiving denials for this code. We appeal with dictation and copy of guidelines showing we coded this correctly and still get denials. Does anyone else have this issue? Has anyone found a way to resolve this issue?
 
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From what I understood if a balloon through the same access as the CVC was used for the disruption of fibrin sheath during a placement, exchange, or removal of the CVC, we were to report 37799. It is when the disruption is through a separate access that the 36595 is used. Since the initial post we have reworded our appeals while still sending the copies of the coding guidelines for support and we are now seeing reversals of the denials and receiving payments. Thank you all for your responses. So nice to be able to reach out to others with IR knowledge for a fresh perspective.
 
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kvo said:
From what I understood if a balloon through the same access as the CVC was used for the disruption of fibrin sheath during a placement, exchange, or removal of the CVC, we were to report 37799. It is when the disruption is through a separate access that the 36595 is used. Since the initial post we have reworded our appeals while still sending the copies of the coding guidelines for support and we are now seeing reversals of the denials and receiving payments. Thank you all for your responses. So nice to be able to reach out to others with IR knowledge for a fresh perspective.
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Hello, Can you refer me to where the coding guidelines are for the 37799? Or attached a link? We also received denials and have updated our letter. Thank you!
 
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Fibrin sheath disruption with balloon dilation remains an unlisted procedure (37799), along with the 36581 and 77001 for the tunneled catheter exchange. There have been no changes to these society recommendations. Do not report 37248 (venoplasty) when balloon disruption of a fibrin sheath is performed. Should anything change, we will be sure to publish it for all to know! -Dr. Z
HTH
 
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