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How to crack this scenario

  1. Default How to crack this scenario
    Exam Training Packages
    My physician perform,

    Left femoral arteriography and right femoral arteriography both are severely diseased. Left subclavian angiography, Left internal mammary artery angiography, Left coronary artery angiography, AORTIC CORONARY SAPHENOUS VEIN GRAFT ANGIOGRAPHY:

    i think that

    93510, 93545, 93556, 93539 are the only codes for this angiogram can anybody help me on this matter.
    Vikas Maheshwari
    Operation Manager (Medical Billing & Coding)
    MBA-HCS, CPC-H

  2. #2
    Location
    Birmingham, Alabama
    Posts
    889
    Default
    Quote Originally Posted by Vikas Maheshwari View Post
    My physician perform,

    Left femoral arteriography and right femoral arteriography both are severely diseased. Left subclavian angiography, Left internal mammary artery angiography, Left coronary artery angiography, AORTIC CORONARY SAPHENOUS VEIN GRAFT ANGIOGRAPHY:

    i think that

    93510, 93545, 93556, 93539 are the only codes for this angiogram can anybody help me on this matter.
    Can you provide the actual report?
    Danny L. Peoples
    CIRCC,CPC

  3. Default
    RIGHT FEMORAL ANGIOGRAPHY: The right common femoral artery is heavily calcified and seve\ely
    diseased. The shpth oritera the rinht nnmmnn femnml There is runoff into the su~erficiafle moral and
    profunda fernoris.

    LEFT FEMORAL ARTERIOGRAPHY: The left common femoral artery is severely diseased and h&vily
    calcified. The sheath enters the left common femoral. There is good runoff into the superficial femoral
    and profunda fernoris.

    LEFT SUBCLAVIAN ANGIOGRAPHY: There is calcif~dpl aque at the origin of the left subclavian, but
    there does not appear to be any obstructive stenosis. Pressure pullback was performed across this area
    and the pressure in the subclavian and the pressure in the left internal mammary artery started at 95 to
    100 systolic, and back in the aorta was 112 systolic and maximum gradient was in the range of 12-15
    mmHg peak gradient.
    LEFT INTERNAL MAMMARY ARTERY ANGIOGRAPHY: Left internal mammary artery appeared
    smooth walled, but was small in caliber, only approximately 2 mm in luminal diameter. It did reach down
    to the level of the diaphragm.
    LEFT CORONARY ARTERIOGRAPHY: The left coronary is highly calcified and severely diseased.
    There is an 80% to 90% ostial left main coronary stehosis, which is heavily calcified. There is flow into
    the left circumflex and then up the bypass graft back close to the origin of the bypass graft in the aorta,
    where it is anastomosed to another limb of the grafl, which then feeds down to the LAD.
    AORTIC CORONARY SAPHENOUS VEIN GRAFT ANGIOGRAPHY: The bypass graft to the LAD and
    obtuse marginal is totally occluded at the aorta.
    Vikas Maheshwari
    Operation Manager (Medical Billing & Coding)
    MBA-HCS, CPC-H

  4. #4
    Location
    Birmingham, Alabama
    Posts
    889
    Default
    Quote Originally Posted by Vikas Maheshwari View Post
    RIGHT FEMORAL ANGIOGRAPHY: The right common femoral artery is heavily calcified and seve\ely
    diseased. The shpth oritera the rinht nnmmnn femnml There is runoff into the su~erficiafle moral and
    profunda fernoris.

    LEFT FEMORAL ARTERIOGRAPHY: The left common femoral artery is severely diseased and h&vily
    calcified. The sheath enters the left common femoral. There is good runoff into the superficial femoral
    and profunda fernoris.

    LEFT SUBCLAVIAN ANGIOGRAPHY: There is calcif~dpl aque at the origin of the left subclavian, but
    there does not appear to be any obstructive stenosis. Pressure pullback was performed across this area
    and the pressure in the subclavian and the pressure in the left internal mammary artery started at 95 to
    100 systolic, and back in the aorta was 112 systolic and maximum gradient was in the range of 12-15
    mmHg peak gradient.
    LEFT INTERNAL MAMMARY ARTERY ANGIOGRAPHY: Left internal mammary artery appeared
    smooth walled, but was small in caliber, only approximately 2 mm in luminal diameter. It did reach down
    to the level of the diaphragm.
    LEFT CORONARY ARTERIOGRAPHY: The left coronary is highly calcified and severely diseased.
    There is an 80% to 90% ostial left main coronary stehosis, which is heavily calcified. There is flow into
    the left circumflex and then up the bypass graft back close to the origin of the bypass graft in the aorta,
    where it is anastomosed to another limb of the grafl, which then feeds down to the LAD.
    AORTIC CORONARY SAPHENOUS VEIN GRAFT ANGIOGRAPHY: The bypass graft to the LAD and
    obtuse marginal is totally occluded at the aorta.
    I would code this:
    93508 (no concomitant LHC)
    93539
    93540
    93545
    93556

    HTH
    Danny L. Peoples
    CIRCC,CPC

  5. Default
    thanks,

    Vikas Maheshwari
    Operation Manager (Medical Billing & Coding)
    MBA-HCS, CPC-H

  6. Default SVG (Saphenous vein graft) angiography
    My physician performed:
    Left heart cath
    select coronary angiography
    saphenous vein graft angiogarphy
    LIMA
    Stent LCX

    I am familiar with everything except the saphenous vein graft angio. I know that this is different than actually grafting, but any ideas how to code for the angio?

    Thanks,
    Amber

  7. #7
    Location
    United Aram Emirates
    Posts
    5
    Default
    Amber,

    I would code

    92980-LC (LCX Stent)
    93510 (Lt Heart Cath)
    93539 (Angiography of Lima)
    93540 (Angiography of Venous Graft)
    93545 (Coronary angiography)
    93556 (If S&I done of native coronary, arterial and venous angiographies)

    Harish, CCS, CPC

  8. Default
    Thank you very much!!

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