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Aortogram w/run-off

  1. Default Aortogram w/run-off
    Medical Coding Books
    If the physician is accessing the left common femoral artery and proceeds to the terminal aorta only (no higher placement) and does an injection and then deflects into the external iliac on the right and into the superficial femoral artery for a PTA and stent placement, do I just bill for CPT 75630 and 37226? On the physician dictation under procedure performed it states he did an Aortogram with Right lower extremity run-off but in the body of the dictation the catheter only went to the level of the aortic bifurcation before deflecting into the right lower extremity for further intervention. I thought to bill for 75625 and 75710/75716 you had to have a high (renals) and low (bifurcation) catheter placement?? Can anyone confirm this for me? Thanks so much!

  2. Default
    I am a CPC-A who is studying this at home while looking for a job, so I'm certainly no authority but it is my understanding that the guiding shots would be bundled if followed by the stent placement. Can you post the report?
    Last edited by K.hancin; 09-27-2011 at 02:08 PM.

  3. #3
    Default I'm learning IVR too.
    Quote Originally Posted by K.hancin View Post
    I am a CPC-A who is trying to learn this at home while looking for a job, so I'm certainly no authority but it is my understanding that the guiding shots would be bundled if it were followed by the stent placement. Can you post the report?
    What are you doing to learn this at home? I've been coding for seven years now and am having to learn this, and it's not easy. I'm doing the coding Metrix classes.

  4. Default
    I'm a CPC for 11 years now and sometimes these things still get confusing. The aortogram and run-off were done prior to intervention to determine if an intervention was needed and in that case can be billed in addition to the intervention of the right lower extremity. I'm not asking about the catheterization as I am the RS&I (70000) codes. I know I can't code the catheter placement itself because it is bundled into the 37226 but what I need to know is if catheterization at only 1 low level of the aorta (aortic bifurcation) vs. a high and low catheter placement (level of the renal arteries and then pulled down to the aortic bifurcation) is coded with 75630 instead of 75625 & 75716. The 70000 codes are not the catheter placement codes but the RS&I codes that are not bundled as long as it was done as a determination that further intervention was needed. Sometimes the physician's seem to conflict themselves in their Op Notes which can make it confusing.

  5. Default
    Quote Originally Posted by nrichard View Post
    What are you doing to learn this at home? I've been coding for seven years now and am having to learn this, and it's not easy. I'm doing the coding Metrix classes.
    I am also studying for my CIRCC certification at home. I ordered a study guide as I did not see any classes being offered for this certification and plan to study the guide and take the exam. What exactly is CPC-A?

  6. #6
    Default
    Quote Originally Posted by HFILSON View Post
    I am also studying for my CIRCC certification at home. I ordered a study guide as I did not see any classes being offered for this certification and plan to study the guide and take the exam. What exactly is CPC-A?
    Someone who's passed the CPC exam w/out two years experiance.
    I'm not studing for the CIRCC, but I have to learn it for my job. I'm currently studying for my COSC and did not find the study guide to be helpful, so I am hesitant to order the study guide for CIRCC. How helpful have you found it? Have you taken the practice exam yet?

  7. Default
    I am about 400-pages into Interventional Radiology Coding by ZhealthPublishing. Thankfully, there are illustrations, graphics and a lot of examples after each concept introduced. Interesting stuff.

    Quote from Interventional Radiology Coding Reference by Z Health Publishing:

    "9. Code 75630 requires imaging of the abdominal aorta, not just the distal most aspect of the aorta. This distal most portion of the aorta is incidentally and routinely seen when a pigtail catheter is injected at the level of the aortic bifurcation for the purpose of the bilateral lower extremity angiography."

    HTH

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