AAPC - Back to school
Results 1 to 2 of 2


  1. #1


    AAPC: Back to School
    Note: The following project was submitted by a non-member. This thread has been left open so you can reply to it. If you believe you are qualified and wish to be contacted, please post your contact details so the non-member may get in touch with you.

    Project Description:
    We opened a vascular access center and I have an E&M question. Our docs do a complete evaluation and management of the patient to make the determination on whether to perform the surgery or not. The nephrologist surgically creates the AV graft and our docs manage the patient's graft. The patient's go to have dialysis and the patient cannot be dialized that day due to a malfunction of graft. The nurse from the dialysis center calls our vascular center and sets up an appt for our docs to evaluate the graft. Depending on the full exam etc...and looking at the graft determines whether the docs do interventional means or send them back for surgical interventiona to their PCP. My question is if our docs are taking over complete care or assuming responsibility of the graft and treatment of the patient can we bill that E&M prior to the intervention? Our docs do a full blown E&M with good documentation.

    Thanks in advance for all your help.

  2. #2

    Default Vascular Access Center question

    Are your doctors employed by the dialysis center? When they are conducting this full-blown E & M, what other organ systems or body areas are they examining? Wouldn't their examination be strictly related to the AV graft and presenting problem? I think you would be shortchanging yourself if you try to bill an additional E & M prior to the intervention. Global days would factor significantly in the processing of your claim, as would appropriate modifier usage.

    It has been my experience that AV graft failure tends to compound over time, necessitating numerous returns during the global period. You would have to append modifier -25 to the E & M if done the same day as the intervention. Check your RVUs and be careful to list the major procedure first, as additional procedures will most likely be reduced, if paid at all.

    Patricia Hayes, MBA, CPC, CMM, CHCC

Similar Threads

  1. US guidance for vascular access ??
    By Rita Bartholomew in forum Interventional Radiology
    Replies: 2
    Last Post: 02-01-2013, 01:19 PM
  2. Replies: 2
    Last Post: 04-20-2011, 02:10 PM
  3. 76942 for vascular access
    By sue37412 in forum Job Postings
    Replies: 1
    Last Post: 02-03-2010, 07:35 AM
  4. Vascular access
    By prabha in forum Interventional Radiology
    Replies: 3
    Last Post: 04-16-2009, 10:30 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.