Wiki Multiple Cardiology Procedures: Cath/renal angiography with balloon angio and stent

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KoBee

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New to cardiology and I think I'm getting myself overwhelmed when searching for the codes but I want to learn. I know some of these are included in others but still confused, HELP please!:confused:

Procedure Performed:
1. RT and LT heart Catherization
2. Aortic valve study
3. Left ventriculogram
4. Coronary angiography
5. Distal abdominal aortography
6. Selective renal angiography with balloon angioplasty and stent placement with a 5.0x18mm heculink placed in the left renal artery proximal.
8. Sheath suture in place. Plan for manual pressure, hold 2 hr post procedure
9. Supervision and interpretation of above.
 
First things you need to know: Is this for a congenital Condition? Are there Bypass Grafts (CABG) present? Assuming none of these are true, this is how I coded it.

37246-26-LT Angioplasty of an Artery (first):Left Side, and 26 for Professional fees only.)
93460-26-51 (angioplasty is a separate procedure, but is subject to multiple procedure discounting. With CABG present, we'd use 93461)
75625-26-59 (Requires 59 because you're doing a procedure on a different site. XS would work too).

CPT Guidelines: Can't use 93565 unless its with a congenital procedure; 93567 cant use it because CPT guidelines and your documentation point to otherwise. We use the imaging code.

michiboo said:
New to cardiology and I think I'm getting myself overwhelmed when searching for the codes but I want to learn. I know some of these are included in others but still confused, HELP please!:confused:

Procedure Performed:
1. RT and LT heart Catherization
2. Aortic valve study- see more specific line 6
3. Left ventriculogram-CPT excluded
4. Coronary angiography-BIL= 93460
5. Distal abdominal aortography 75625-XS-26
6. Selective renal angiography with balloon angioplasty and stent placement with a 5.0x18mm heculink placed in the left renal artery proximal. 37246
8. Sheath suture in place. Plan for manual pressure, hold 2 hr post procedure (included in procedure)
9. Supervision and interpretation of above.
Click to expand...
(implies modifier 26)

I hope this helps

Jack
 
jacksycz said:
First things you need to know: Is this for a congenital Condition? Are there Bypass Grafts (CABG) present? Assuming none of these are true, this is how I coded it.

37246-26-LT Angioplasty of an Artery (first):Left Side, and 26 for Professional fees only.)
93460-26-51 (angioplasty is a separate procedure, but is subject to multiple procedure discounting. With CABG present, we'd use 93461)
75625-26-59 (Requires 59 because you're doing a procedure on a different site. XS would work too).

CPT Guidelines: Can't use 93565 unless its with a congenital procedure; 93567 cant use it because CPT guidelines and your documentation point to otherwise. We use the imaging code.

(implies modifier 26)

I hope this helps

Jack
Click to expand...

I have to disagree with what you have Jack. With the heart, a right and left heart cath was performed along with a supravalvular aortogram ( if documented). That is coded 93460 and 93657. For the renals, we have selective renal arteriogram, so the abdominal aortogram is bundled in the renal arteriogram code. So 36252-xs or 59 is coded. Then a stent is placed in the Left Renal artery. This will be coded 37236-LT,59. There is not any mention of bypass grafts, so I would not worry about 93461 ( although a full report would have been nice to confirm). Add modifier-26 if your coding for the doctor.

Thanks,
Jim Pawloski, CIRCC
 
Jim Pawloski said:
I have to disagree with what you have Jack. With the heart, a right and left heart cath was performed along with a supravalvular aortogram ( if documented). That is coded 93460 and 93657. For the renals, we have selective renal arteriogram, so the abdominal aortogram is bundled in the renal arteriogram code. So 36252-xs or 59 is coded. Then a stent is placed in the Left Renal artery. This will be coded 37236-LT,59. There is not any mention of bypass grafts, so I would not worry about 93461 ( although a full report would have been nice to confirm). Add modifier-26 if your coding for the doctor.

Thanks,
Jim Pawloski, CIRCC
Click to expand...


Appreciate the feedback but I have some questions: I have matched the codes next to procedures, now shouldn't the stent be priority? and why 36252 (bilateral)? why 93657? sorry not understanding.



93460 - 26
37259 - LT,26,59
36252 - 26, 59

Procedure Performed:
1. RT and LT heart Catherization =93460
2. Aortic valve study
3. Left ventriculogram = 93460
4. Coronary angiography = 93460
5. Distal abdominal aortography = 36252 -59
6. Selective renal angiography with balloon angioplasty and stent placement with a 5.0x18mm heculink placed in the left renal artery proximal. = 37236 -LT
8. Sheath suture in place. Plan for manual pressure, hold 2 hr post procedure
9. Supervision and interpretation of above.
 
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