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bypass graft

  1. #1
    Default bypass graft
    Medical Coding Books
    Does anyone know the reason CPT says you can't report 35535 with 35536 in the instructional note after the code 35535?
    My surgeon did two grafts, hepatoreanal on the right, and splenorenal on the left.
    I would think I should be able to report both.

  2. #2
    Location
    Milwaukee WI
    Posts
    4,466
    Default 59 modifier and appeal
    This is NOT my area of expertise, but ...

    Clearly he performed two separate grafts, so you should be able to code for both. I would use the -59 modifier on the second code ... and perhaps the RT / LT modifiers? (I'm out of my element here.)

    Certainly watch for the reimbursement. You will likely get a denial and need to appeal with the medical records to show that clearly there were two separate grafts done.

    Good luck! And let us know how it turns out.

    F Tessa Bartels, CPC, CEMC

  3. #3
    Default
    I agree with Tessa

  4. #4
    Thumbs up Agreed
    This seems to be a perfect answer. Use modifier 59 with second graft with RT/LT.

    Girish Dadhich, CPC

  5. #5
    Default
    2 arterial bypass grafts would be a 33534.....
    if you bill a 33535 - thats 3 BYPASS'S + 33536 (4 plus bypass's)
    So you are looking at 7+bypass's...

    Maybe I am reading this wrong . But if it's 2 bypass artery grafts it would be 33534 only. Please let me know if I am reading this wrong.

  6. #6
    Location
    Milwaukee WI
    Posts
    4,466
    Default 3 5 5 3 5
    Quote Originally Posted by Ajacquinto View Post
    2 arterial bypass grafts would be a 33534.....
    if you bill a 33535 - thats 3 BYPASS'S + 33536 (4 plus bypass's)
    So you are looking at 7+bypass's...

    Maybe I am reading this wrong . But if it's 2 bypass artery grafts it would be 33534 only. Please let me know if I am reading this wrong.
    I made the same error when I first read the post ... the poster is NOT talking about coronary artery bypass ... but hepatorenal (35535) and splenorenal (35536)

    Easy mistake to make.
    F Tessa Bartels, CPC, CEMC

  7. #7
    Default
    Quote Originally Posted by FTessaBartels View Post
    I made the same error when I first read the post ... the poster is NOT talking about coronary artery bypass ... but hepatorenal (35535) and splenorenal (35536)

    Easy mistake to make.
    F Tessa Bartels, CPC, CEMC
    OOOO Yes... caught it now.. thanks.. Disregard my response..

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