Category: CC-Vascular

Modifier 52 vs. 53
Post

Modifier 52 vs. 53

January 19, 2023 Question: We are confused about the difference between modifier 52 and 53. What is the difference? Answer: Modifier 52 Reduced Services is used when the procedure or surgery is partially reduced or eliminated by the physician. This is used when a procedure has an existing CPT code, but not all of the...

Consultation Coding in 2023
Post

Consultation Coding in 2023

December 15, 2022 Question: In 2023, will the level of service be determined by history, exam and medical decision making, or will this change? I have heard it is changing. Answer: Beginning January 1, 2023, consultation codes 99242-99255) for both inpatient and outpatient services will be based on medical decision making or time. However, keep...

2021 E/M Coding Guidelines
Post

2021 E/M Coding Guidelines

December 1, 2022 Question: In the 2021 E/M revision guidelines, how does Time affect billing for a teaching physician’s E/M service when the resident spends a great deal of time with the patient? Answer: Good question! Only the time of teaching physician would “count” in the scenario you describe. The new guidelines say that the...

Stent vs. Embolization or Both
Post

Stent vs. Embolization or Both

November 17, 2022 Question: If the surgeon uses a covered stent and performs an embolization on a patient with a pseudoaneurysm, can we bill for both the stent and removal of the embolus? Answer: If a covered stent is deployed as the sole management of an aneurysm, pseudoaneurysm or vascular extravasation, then the stent deployment...

Dialysis Circuit Revision
Post

Dialysis Circuit Revision

November 3, 2022 Question: My vascular surgeon performed a dialysis circuit open revision, and had to remove subcutaneous fat during the procedure. He said this was a more complex procedure than usual, so is there another code to use besides 36832? Answer: Removing excess subcutaneous fat is included in the work for 36832, so this...

Billing Separately for Diagnostic Angiograms
Post

Billing Separately for Diagnostic Angiograms

October 20, 2022 Question: Our surgeon performed an aortogram with run-off to bilateral lower extremities. He then performed interventions in the left SFA and the left peroneal arteries. My question is regarding documentation of the diagnostic imaging Can he also bill for a diagnostic angiogram? What about catheterization to get there? Answer: Diagnostic imaging during...

Confusion About New 2021 E/M Guidelines
Post

Confusion About New 2021 E/M Guidelines

October 6, 2022 Question: The new guidelines that are coming out in 2021 for all types of E/M services, right? Answer: No. The new guidelines are for office/outpatient visit codes only (99202-99215). You will still need to use the current guidelines for all other E/M services, even consultations in the office. But good news, the...

Overreading a Diagnostic Imaging Study
Post

Overreading a Diagnostic Imaging Study

September 22, 2022 Question: I sent a patient out to the hospital for a CTA and the patient brought in the actual images and the radiologist’s report for me to review. Can I charge 76140 (Consultation on X-ray examination made elsewhere, written report) when I personally interpret those images and write my own report? Answer:...

Billing for Lesion Intervention Crossing Territories
Post

Billing for Lesion Intervention Crossing Territories

August 25, 2022 Question: Our vascular surgeon documented a single intervention for a lesion that crosses the margin between the fem/pop and tibial/peritoneal territories. Should we bill one code or one for each territory? Answer: You would bill one code since a single intervention was performed, even though it crossed into another territory. *This response...

Sign up for KZAlertsSign up for KZAlerts

Coding Coaches