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Wiki Vasculary Surgery Billing Help Please!

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mm0105

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When pre-authorizing abdominal aortogram with bilateral lower extremity run-off, code 75635 is used. However, no CT machine available, then surgeon intervenes with stenting, atherectomy, etc. How do we pre-authorize and get paid for intervention when we don't know ahead of time which method of intervention will be used? The hospital side is billing 75716 with intervention codes. The hospital is ONLY being paid for the 75716 and not for the intervention. We need to know how to get this correctly authorized so both the physician and the hospital are reimbursed properly. Any help is appreciated!!
 
I am the CPC in our office, and when the girl in charge of precert asks me for codes for an aortogram (75625 etc,) I check to see in the physician's notes if there is the possibility of intervention. If so, I go ahead and give her all the possible codes. (eg: 37205 stent + 75960 S & I.) Many insurance companies wont allow you to provide that many codes for precert, but you can at least attempt to provide them.
 
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