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cryoablation kidney

  1. Default cryoablation kidney
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    My codes for the below procedure are
    50593
    77013-26
    76940-2659.Do we need to code the biopsy of kidney seperately or it is included in cryoablation?

    The patient was placed prone on the CT table. Serial axial 5 mm
    scan was obtained through the abdomen without intravenous
    contrast. These images demonstrated a round exophytic mass the
    left kidney. After identifying the proper access sites in the left
    Flank, 3 Cryoablation probes 2.4 mm in diameter were deployed
    through the lesion under US and CT guidance. 18 G Core needle
    biopsy of the mass was performed, and samples sent for pathologic
    evaluation.

    After proper probe positioning was reconfirmed by repeat CT
    imaging, freezing and thawing according to the standard protocol
    was performed. (10 minute freeze, 8 minute thaw, 10 minute freeze,
    and final thaw).

    Repeat images during the procedure confirmed proper ice ball
    formation showing at least 1 cm margin of lethal ice outside of
    the mass boundaries.

    The probes were removed. Follow-up CT imaging without contrast
    demonstrated no hemorrhage.

    The patient tolerated the procedure well and left the department
    in stable condition.

    IMPRESSION:
    1. Successful cryoablation of the exophytic mass in the left
    Kidney.
    2. Biopsy of the mass with 18 G core needle.
    Prabha CPC

  2. #2
    Default
    surely we need to code the biopsy of kidney seperately 50200 and is not included in cryoablation and the S & I code for biopsy is only 76942 not 76940 beacuse cryoablation done under CT guidance not under ultrasound.
    Last edited by drspatil; 07-23-2009 at 05:00 AM. Reason: us

  3. Default
    Quote Originally Posted by prabha View Post
    My codes for the below procedure are
    50593
    77013-26
    76940-2659.Do we need to code the biopsy of kidney seperately or it is included in cryoablation?

    The patient was placed prone on the CT table. Serial axial 5 mm
    scan was obtained through the abdomen without intravenous
    contrast. These images demonstrated a round exophytic mass the
    left kidney. After identifying the proper access sites in the left
    Flank, 3 Cryoablation probes 2.4 mm in diameter were deployed
    through the lesion under US and CT guidance. 18 G Core needle
    biopsy of the mass was performed, and samples sent for pathologic
    evaluation.

    After proper probe positioning was reconfirmed by repeat CT
    imaging, freezing and thawing according to the standard protocol
    was performed. (10 minute freeze, 8 minute thaw, 10 minute freeze,
    and final thaw).

    Repeat images during the procedure confirmed proper ice ball
    formation showing at least 1 cm margin of lethal ice outside of
    the mass boundaries.

    The probes were removed. Follow-up CT imaging without contrast
    demonstrated no hemorrhage.

    The patient tolerated the procedure well and left the department
    in stable condition.

    IMPRESSION:
    1. Successful cryoablation of the exophytic mass in the left
    Kidney.
    2. Biopsy of the mass with 18 G core needle.

    According to CCI edits, the biopsy is not bundled with the ablation, and since it was properly documented, it is billable.

    Patti Downing, RCC

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