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Another in Need of Vascular Help!

  1. #1
    Red face Another in Need of Vascular Help!
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    I am also new to vascular coding and would appreciate help with the following:

    Dr performed Aortobifemoral bypass w/PTFE graft. I think 35646 is the appropriate code, but I don't know if the following sentence represents an additional service - " the peritoneum was entered and a small amount of adhesions were taken down". I'm thinking 44005 -enterolysis of intestinal adhesions.
    My biggest difficulty is in determing what is included in the primary procedures and what is separately billable. Any advice on good reference books/materials/conferences?

    Thanks for any and all help!

  2. #2
    Central Indiana
    Lysis of adhesions is included in the primary vascular procedure code. There have been cases where the adhesions are SO extensive and time-consuming that I have billed for this additionally, however "a small amount of adhesions" is to be expected in the encounter and isn't billable seperately.

    Vascular coding is a very gray world... I've been doing it over 3 years and still don't have all the answers! The experts don't always have all the answers either. If you will be doing more endovascular procedures, I highly recommend Medical Asset Management, Inc. and ZHealth. Best wishes and good luck!

  3. #3
    Another good book is Ingenix Coding Companion Cardiology/Cariothoracic surgery/Vascular Surgery. Also there's a conference in Chicago next month, Challenges in Vascular Surgery: Coding & Reimburement for Vascular Surgeons. I went to the conference for the first time after coding for Vascular Surgeons for 5 months. It gave me a better understanding of Vascular Coding. Its worth attending. Maybe you should speak with your office manager, they may be interested in sending you to the conference.

  4. Default
    I'm a little late to the game here, but I agree with the user above - the SVS courses are great. They usually hold two per year - one in Chicago and one somewhere else. We've gone the past three years and have taken away a lot of great information, especially last year when we were all getting ready for the lower extremity revascularization changes. It's really well worth the money to attend at least once, especially if you're new to vascular coding.

    Kim Hoffman, CPC
    University Vascular Surgery

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