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Discontinued Procedure

  1. #1
    Question Discontinued Procedure
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    Our doc previously tried to do a procedure, but had to stop as he could not even put the guidewire into the vessels to do the percutaneous surgery. We billed the claim as 37220-53, to indicate that it was discontinued. It has been denied and/or not paid. I'm thinking that because there was really nothing done, we can't really charge anything in the first place. But I want to know what others think first. We're sending it to Medicare, and I'm not sure on their policies with discontinued services. Can or should we fight it? Or can I go ahead and just write it off?

  2. #2
    Question
    Quote Originally Posted by eaglecloudnebula@yahoo.com View Post
    Our doc previously tried to do a procedure, but had to stop as he could not even put the guidewire into the vessels to do the percutaneous surgery. We billed the claim as 37220-53, to indicate that it was discontinued. It has been denied and/or not paid. I'm thinking that because there was really nothing done, we can't really charge anything in the first place. But I want to know what others think first. We're sending it to Medicare, and I'm not sure on their policies with discontinued services. Can or should we fight it? Or can I go ahead and just write it off?
    I had this same case come across my desk today. I coded/billed it the same way....Will let you know what happens w/payment...
    Yolanda T. Haskins CPC, CRC, OHCC, AAPC Fellow
    Past AAPCCA Board of Directors 2014 - 2017


    Alexandria, VA Chapter

    ~ Practice Kindness ~

  3. #3
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    Alexandria, LA
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    What did he actually do? Did he just ultrasound and see the artery was blocked?
    Did he catheterize and do an angio and see that the artery was blocked? If, in the attempt to do one procedure he did a lesser procedure, then you would code the lesser procedure and not the major.

  4. #4
    Default
    Quote Originally Posted by donnajrichmond View Post
    What did he actually do? Did he just ultrasound and see the artery was blocked?
    Did he catheterize and do an angio and see that the artery was blocked? If, in the attempt to do one procedure he did a lesser procedure, then you would code the lesser procedure and not the major.
    He went in knowing that he was going to stent the iliac artery, but "multiple attempts to cannulate the artery failed and the wire would not go through. after about 7 attempts I decided to stop the procedure".

    Do you think that I could code for the downgraded catheter placement (36246-52)?

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