SaraCicero
Guest
A specific Example:
In this example IVUS was performed in Superficial Femoral Artery, Popliteal, AT, and Dorsel Pedis. Should this have been coded as 37252 and 37253 only? The fem pop would be one code, and AT+ DP would be a second? Or should we be coding per vessel and show fem pop as one, AT as 1 unit and DP as a second unit (37252 and 37253x2).
General Question:
The bottom line is that we are being denied for excess billing for the IVUS, and I think it is because we are coding each named vessel without regard for the inclusion coding instructions. Of course we realize that 37253 is counted by additional vessels treated, but the issue is that it is being counted as an additional vessel when it is included for coding in another vessel. For instance, the femoral and popliteal arteries are always coded together as one vessel. The tibeoperoneal trunk is not considered a separate vessel for coding, and is included in either the posterior tibeal or the peroneal, or if neither one of those is done, it can be counted on it's own as included in the posterior tibal.
The dorsalis pedis is considered an extension of the anterior tibeal and the plantar arteries are considered and extension of the posterior tibial. Do I have this correct?
If so, this grouping should be identical to the grouping used for the interventions, and counted together the same way.
If you can give reference, that would help, going back and forth with the practice on this one for a bit.
In this example IVUS was performed in Superficial Femoral Artery, Popliteal, AT, and Dorsel Pedis. Should this have been coded as 37252 and 37253 only? The fem pop would be one code, and AT+ DP would be a second? Or should we be coding per vessel and show fem pop as one, AT as 1 unit and DP as a second unit (37252 and 37253x2).
General Question:
The bottom line is that we are being denied for excess billing for the IVUS, and I think it is because we are coding each named vessel without regard for the inclusion coding instructions. Of course we realize that 37253 is counted by additional vessels treated, but the issue is that it is being counted as an additional vessel when it is included for coding in another vessel. For instance, the femoral and popliteal arteries are always coded together as one vessel. The tibeoperoneal trunk is not considered a separate vessel for coding, and is included in either the posterior tibeal or the peroneal, or if neither one of those is done, it can be counted on it's own as included in the posterior tibal.
The dorsalis pedis is considered an extension of the anterior tibeal and the plantar arteries are considered and extension of the posterior tibial. Do I have this correct?
If so, this grouping should be identical to the grouping used for the interventions, and counted together the same way.
If you can give reference, that would help, going back and forth with the practice on this one for a bit.