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Embolization - Do we need to add any catheter

  1. Default Embolization - Do we need to add any catheter
    Medical Coding Books
    Can anyone help me out with this procedure.My codes are
    37204
    75894-26
    75898-26
    Do we need to add any catheter code.Pls confirm whether my codes are correct?
    Procedure. Translumbar embolization of a type II leak.

    Clinical information status post EVAR with type II leak. The
    patient had previously had a translumbar embolization and arterial
    embolization of the inferior mesenteric artery from the SMA.

    Procedure.
    Informed consent was obtained. The patient was prepped and draped
    appropriately after being turned prone. After infiltration with
    local anesthesia, an 18-gauge needle was advanced into the type II
    leak using the previously placed coils as a marker.

    Contrast injection demonstrates two contiguous sacs, the
    lowermost of which filled the IMA passed the previously placed
    coils. No other inflow or outflow was demonstrated.
    An exchange was made for a 4-French Cobra catheter and attempts
    made to catheterize the IMA without success. Accordingly the
    lowermost sac was filled with 4 6 mm Nester coils and 2 4 mm
    Nester coils to make a dense nest. A 10-mm coil was placed in the
    uppermost sac. Contrast injection demonstrated no flow.

    Impression. Translumbar embolization of a type II leak from the
    IMA.
    Prabha CPC

  2. Default
    What I am getting from that dictation is that they could not place the catheter, therefore you cannot code it.

    An exchange was made for a 4-French Cobra catheter and attempts
    made to catheterize the IMA without success.
    Hope that helps.
    Heidi

  3. #3
    Location
    Birmingham, Alabama
    Posts
    889
    Default
    Quote Originally Posted by prabha View Post
    Can anyone help me out with this procedure.My codes are
    37204
    75894-26
    75898-26
    Do we need to add any catheter code.Pls confirm whether my codes are correct?
    Procedure. Translumbar embolization of a type II leak.

    Clinical information status post EVAR with type II leak. The
    patient had previously had a translumbar embolization and arterial
    embolization of the inferior mesenteric artery from the SMA.

    Procedure.
    Informed consent was obtained. The patient was prepped and draped
    appropriately after being turned prone. After infiltration with
    local anesthesia, an 18-gauge needle was advanced into the type II
    leak using the previously placed coils as a marker.

    Contrast injection demonstrates two contiguous sacs, the
    lowermost of which filled the IMA passed the previously placed
    coils. No other inflow or outflow was demonstrated.
    An exchange was made for a 4-French Cobra catheter and attempts
    made to catheterize the IMA without success. Accordingly the
    lowermost sac was filled with 4 6 mm Nester coils and 2 4 mm
    Nester coils to make a dense nest. A 10-mm coil was placed in the
    uppermost sac. Contrast injection demonstrated no flow.

    Impression. Translumbar embolization of a type II leak from the
    IMA.

    My initial thought is, this is not a transcatheter embolization (37204) but I don't have enough information to give an alternative. What is an EVAR?
    Danny L. Peoples
    CIRCC,CPC

  4. Default
    endovascular aneurysm repair
    Anthony McCallum, CPC, CIRCC, CPC-I, CCS
    ciphermed@optonline.net

  5. #5
    Location
    Birmingham, Alabama
    Posts
    889
    Default
    Quote Originally Posted by ciphermed View Post
    endovascular aneurysm repair

    Thanks Anthony. I have coded hundreds of those and don't remember our surgeons using that acronym.

    Based on that, I would code as such:
    37204/75894.
    36160
    and 75898

    HTH
    Last edited by dpeoples; 09-18-2009 at 08:31 AM.
    Danny L. Peoples
    CIRCC,CPC

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