Wiki Return to the OR for Thrombolytic infusion catheter

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mfournier

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Hello Everyone:

Was hoping someone can help with this issue.
Patient had a 37211, 36247-51 and 75710-26-59 on 4/5. On the same day while patient was in recovery the catheter were abruptly pulled and retracted out. The sheath and the catheter were still inside her body, but I recommended urgently taken her back to reposition the catheter. 37213-58-RT was billed with DOS 4/5 and Medicare denied "This procedure or procedure/modifier combination is not compatible with another procedure or procedure/modifier combination provided on the same day.

Should I do a reconsideration stating this was a return to the OR or should I select a different code?

Any suggestions would be greatly appreciated.

Thanks
Miriam F
 
mfournier said:
Hello Everyone:

Was hoping someone can help with this issue.
Patient had a 37211, 36247-51 and 75710-26-59 on 4/5. On the same day while patient was in recovery the catheter were abruptly pulled and retracted out. The sheath and the catheter were still inside her body, but I recommended urgently taken her back to reposition the catheter. 37213-58-RT was billed with DOS 4/5 and Medicare denied "This procedure or procedure/modifier combination is not compatible with another procedure or procedure/modifier combination provided on the same day.

Should I do a reconsideration stating this was a return to the OR or should I select a different code?

Any suggestions would be greatly appreciated.

Thanks
Miriam F
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The book I have, Revenue Cycle Coding Strategies Navigator for Interventional Radiology/Procedures, states 37211 includes catheter initiation, repositioning, exchange and discontinuation.

Hope this helps.
 
I would charge 37211-78 as reposition of catheter. Each infusion code goes by the day, so since that is the initial day that is why I used 37211.
HTH,
Jim Pawloski, CIRCC
 
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