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AV Fistula intervention

  1. #1
    Location
    Richardson, TX
    Posts
    822
    Default AV Fistula intervention
    Medical Coding Books
    Question: Can you bill venous atherectomy (37799) AND Thrombectomy (36870) in a Fistula? Medicare is telling me it is global. I'm assuming they only want to pay one or the other but I can't find any documentation stating you can't bill these two together. I have Dr. Z book too and can't find anything in there either.

    Any guru's out there??? PLEASE! Thanks a million.

    Happy Friday
    Julie Graham, BA, CPC, CCC

  2. #2
    Location
    Birmingham, Alabama
    Posts
    889
    Default
    Quote Originally Posted by jewlz0879 View Post
    Question: Can you bill venous atherectomy (37799) AND Thrombectomy (36870) in a Fistula? Medicare is telling me it is global. I'm assuming they only want to pay one or the other but I can't find any documentation stating you can't bill these two together. I have Dr. Z book too and can't find anything in there either.

    Any guru's out there??? PLEASE! Thanks a million.

    Happy Friday
    just a couple of thoughts...was this performed at the same session? If so, the global period is irrelevant. If they were not performed in the same setting but during the global period of 36870, then apply a modifier 58,78, or 79 to the unlisted code.

    If 37799 is bundling with 36870 (same session), and is clearly a separe proceure, with separate documentation, then you could try modifier 59. Be advised that overuse of modifer 59 can raise red flags.


    HTH
    Danny L. Peoples
    CIRCC,CPC

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