CULINTZ
Networker
For FY17 ICD-10-PCS, the index entries for restriction of abdominal aorta, thoracic aorta, and common iliac arteries default to intraluminal device, branched or fenestrated. Is the default of "branched or fenestrated" correct? This appears to be an error. I checked with a rep from Medtronics today concerning the Medtronics Endurant endograft and was advised that this is not a branched/fenestrated device. This device was used in an AAA repair that I reviewed today. Thanks for any insight.
For those who might be interested in what I've found out:
Hi Caroline
I'm interested in this topic because I'm the coding consultant who wrote the C&M proposal for fenestrated and branched endografts. I came up with the PCS code table changes to identify branched and fenestrated endografts, though I didn't have anything to do with the new Index entries. In practice, I rarely even use the Index. Laura and Dotsy are giving you good advice: endografts for aneurysms are definitely coded using the Restriction code tables 02V and 04V but you still have to select the device value case-by-case. Most endografts are not branched or fenestrated, so definitely don't default there. In fact, branched and fenestrated endografts are almost all custom made at this point, based on measurements for each individual patient. Part of the problem too is that some endograft models have the same or similar brand names but can come in both branched/fenestrated and non-branched/non-fenestrated varieties. So read the procedure report very carefully and watch the description of the device!
FYI, people have said that the slides on branched and fenestrated endografts that were shown at the C&M meeting are very handy in helping to understand these devices. You can pick up the slides at the C&M website (September 2015 meeting):
https://www.cms.gov/Medicare/Coding...=1&DLEntries=10&DLSort=0&DLSortDir=descending
For those who might be interested in what I've found out:
Hi Caroline
I'm interested in this topic because I'm the coding consultant who wrote the C&M proposal for fenestrated and branched endografts. I came up with the PCS code table changes to identify branched and fenestrated endografts, though I didn't have anything to do with the new Index entries. In practice, I rarely even use the Index. Laura and Dotsy are giving you good advice: endografts for aneurysms are definitely coded using the Restriction code tables 02V and 04V but you still have to select the device value case-by-case. Most endografts are not branched or fenestrated, so definitely don't default there. In fact, branched and fenestrated endografts are almost all custom made at this point, based on measurements for each individual patient. Part of the problem too is that some endograft models have the same or similar brand names but can come in both branched/fenestrated and non-branched/non-fenestrated varieties. So read the procedure report very carefully and watch the description of the device!
FYI, people have said that the slides on branched and fenestrated endografts that were shown at the C&M meeting are very handy in helping to understand these devices. You can pick up the slides at the C&M website (September 2015 meeting):
https://www.cms.gov/Medicare/Coding...=1&DLEntries=10&DLSort=0&DLSortDir=descending
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