Wiki Interventional Procedures

[mariap]

Our vascular physicians have been told that they can bill for attempted angioplasty/stent placement. We have received conflicting information as to whether we can bill for this or not and what modifier is appropriate...52 or 53? Anyone doing this?? Thanks.

 

[Heidi Bass]

Hi,
You can bill for an attempt, there is a lot of discrepancy as to when to bill it. We use the -52 if the physician crosses the lession, but is unable to deploy the balloon or stent. The other time we do this is if he does get the balloon or stent into the lession, but the devices fails. We use -53 if the procedure is aborted due to the patients health, they go into v-tach and the device was in the artery, but it is too risky to continue. Generally in this case there is a code called. Cardiology Coding Alert, Cardiology Pink Sheet and the Cardiology Colation have articles, but I don't remember the dates.

Heidi Bass, ACS-CA, CPC, CCS-P
Heart Center of the Rockies

 

[MLS2]

The following is per the Interventional Radiology Coding Users' Guide 2008:

"If one attempts in a serious and bona fide manner to perform a service and is unsuccessful but has in the attempt performed a lesser service, then the lesser service is coded. As an example, an unsuccessful attempted aortic access from a right femoral approach (failed because of an iliac occlusion); the service should be coded as 36140 rather than 36200. If an angioplasty of an occlusion is unsuccessful because the lesion cannot be crossed, then the appropriate access and/or selection only should be coded. On the other hand, if the lesion is crossed and the angioplasty is performed but with an unacceptable outcome, then the angioplasty is coded since all the work of the angioplasty was done. If significant portions of a procedure are performed, but the procedure must be terminated prematurely, due to extenuating circumstances or those that threaten the well being of the patient, a -53 modifier may be used."