This is a complete shot in the dark here...but to me it sounds like the external biliary cath was removed and a guidewire placed just to keep the site opened and to keep the cath from being in the way before the patient went to the OR for their GI stent procedure and then returned to the IR department to "replace" the external cath. Did the report give you any indication why the biliary cath needed to be removed? If it was due to obstruction/malfunction then I would say that the guidewire & diagnostic cath mentioned in the first part would be inherent to the return IR visit where the biliary cath was replaced and you would charge 47525/75984 (C1729 for the cath but in most cases it's not payable separately and considered a packaged service/item). If it was removed only as prevention/precaution for the GI stent procedure then I do not think it should be charged as a replacement.....could be wrong on that one so I'm emailing an expert from Medlearn to clarify......maybe an E/M but just from the info you provided it does not sound like this was a diagnostic procedure that can be billed.
Danny, what do you think because I know you're about to disagree with me!!!!
Anita W, CIRCC, RCC, CPMA, CPC