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Cross over technique with run off

  1. Question Cross over technique with run off
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    Hi to all,

    Need your opinion on how to code the following;
    1. Selective angiography of right common iliac.
    2. Selective angiography of the right femoral artery with runoff to the right lower extremity using a cross-over technique.
    3. Selective angiography of the right popliteal artery with a runoff to the right lower extremity using a cross-over technique.

    I do appreciate all your help.

    Thanks

    Bhong

  2. #2
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    Quote Originally Posted by bhong View Post
    Hi to all,

    Need your opinion on how to code the following;
    1. Selective angiography of right common iliac.
    2. Selective angiography of the right femoral artery with runoff to the right lower extremity using a cross-over technique.
    3. Selective angiography of the right popliteal artery with a runoff to the right lower extremity using a cross-over technique.

    I do appreciate all your help.

    Thanks

    Bhong
    First, where did the catheter go? Was it placed in each of the vessels or just at the rt common iliac, and where was the entry point. I will make a assumption that it was from the left femoral artery since you say cross over technique. Otherwise I would say 75710 for rt extremity angio.

    I hope thats helps,
    Jim Pawloski

  3. #3
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    the selectively code for popiteal artery is the 3rd oder so this would be 36247 and unilateral extrem 75710,26. thanks vick

  4. Default
    Hi,
    You guess it right Jim, the point of entry was on the left Femoral artery, and selective angiography was obtained on the right commom iliac artery with runoff to the right lower extremity. is it right to use code 36246 and 75630 26 for it? and what about the selective angiography of the right femoral artery with runoff to the right lower extremity using a cross-over technique could I still use the 75630 26 but with modifier 59 on it or the 75710 26 59, the wire was then advance to mid superficial femoral when the angio was taken.

    I really get confused with the runoff and the cross-over techniques, i really appreciate your help on this.

    Thank you.

    Bhong

  5. #5
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    Quote Originally Posted by bhong View Post
    Hi,
    You guess it right Jim, the point of entry was on the left Femoral artery, and selective angiography was obtained on the right commom iliac artery with runoff to the right lower extremity. is it right to use code 36246 and 75630 26 for it? and what about the selective angiography of the right femoral artery with runoff to the right lower extremity using a cross-over technique could I still use the 75630 26 but with modifier 59 on it or the 75710 26 59, the wire was then advance to mid superficial femoral when the angio was taken.

    I really get confused with the runoff and the cross-over techniques, i really appreciate your help on this.

    Thank you.

    Bhong

    First, you code where the catheter went, not the wire. So In this case, the catheter was in the left common iliac artery. That is a first order catherization which is coded 36245. You lose the aortic catheterization when the catheter goes selective. I would bill the S&I part 75710, since they are looking at the extremity. So remember, for the "cross-over" or "over the horn", common iliac on the contralateral side is first order, external iliac- common femoral is second order, sfa is third order.
    Hope that helps you out.
    Thanks,
    Jim Pawloski
    Last edited by Jim Pawloski; 12-16-2009 at 09:20 AM. Reason: Oops, thinking of a case I did

  6. #6
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    Quote Originally Posted by Jim Pawloski View Post
    First, you code where the catheter went, not the wire. So In this case, the catheter was in the left common iliac artery. That is a first order catherization which is coded 36245. You lose the aortic catheterization when the catheter goes selective. I would bill the S&I part 75710, since they are looking at the extremity. So remember, for the "cross-over" or "over the horn", common iliac on the contralateral side is first order, external iliac- common femoral is second order, sfa is third order.
    Hope that helps you out.
    Thanks,
    Jim Pawloski
    Based on the information given I agree with Jim, all that is documented is
    36245/75710.

    HTH
    Danny L. Peoples
    CIRCC,CPC

  7. Default
    Hi,

    Yes! you are right, now i understand it more, maybe i was intimidated by the word "cross-over and runoff" so i was hesitant to use it. Jim THANK YOU very much for that enlightenment.

    Hope to hear from you in my future queries...

    Again Thank You!


    Bhong

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