August 17, 2023 Question: We use a Physician-Modified Endovascular Graft (PMEG) for our FEVAR procedures. Do we have to bill this with an unlisted code? Answer: No, use of a PMEG does not require billing as an unlisted code. Use the existing FEVAR codes based on endograft coverage and number of fenestrations. *This response is...
August 3, 2023 Question: Are diagnostic angiogram billable with a lower extremity intervention, such as an atherectomy or stent? I’ve been told they are bundled. Answer: That is a common misunderstanding. Diagnostic angiograms are separately billable during a lower extremity intervention such as an atherectomy or stent intervention if no prior adequate diagnostic angiogram is...
July 20, 2023 Question: When acting as an assistant surgeon, should I dictate a separate operative note? Answer: No. In a scenario with a primary and assistant surgeon, only the primary surgical dictates the operative note. Importantly, in that note, the specific role of the assistant must be documented. This should be more specific then,...
July 6, 2023 Question: My vascular surgeon partner and I performed an EVAR together. Is this reported as co-surgery? Answer: Co-surgery is defined as two surgeons doing distinct and separate parts of a single CPT code. The intent is that the two surgeons have different skill sets; be of a different surgical specialty. You and...
June 8, 2023 Question: An aortogram and renal angiogram are performed and documented. Can both be billed? Answer: No, an aortogram is included in the renal angiogram. Report only the renal angiography, 36251, unilateral or 36252, bilateral for selective catheter placement ( in the main renal artery). 36251 Selective catheter placement (first-order), main renal artery...
May 11, 2023 Question: What code is used to make an incision over the femoral artery to evaluate for injury, and explore it without any repair? Answer: Use code 35703, Exploration not followed by surgical repair, artery; lower extremity (eg, common femoral, deep femoral, superficial femoral, popliteal, tibial, peroneal) *This response is based on the...
April 27, 2023 Question: A patient with a clot in the femoral artery had overnight infusion of thrombolytics. When the catheter was removed the next day, the doctor place a stent in the same artery, the superficial femoral . can both be billed? Answer: Yes, the removal of the catheter, 37214 is billed in addition...
April 13, 2023 Question: When choosing the level of E&M we are confused about the History and Exam. If we choose a level of E&M based on time, does this time count toward total time, or is it only time spent on MDM? Answer: When choosing a level of E&M based on time, CPT identifies...
March 30, 2023 Question: We have a patient with 2 commercial payers (BCBS and Cigna). A consultation code was submitted to BCBS, and they paid according to our contract. However, Cigna is refusing to process the claim since they no longer pay for consult codes. Am I allowed to change the CPT code and rebill...
March 16, 2023 Question: Our vascular surgeon did a single intervention on a lesion that was at the juncture of the femoral/popliteal and tibial/peritoneal territories. Can we charge for two interventions? Answer: Lesions that extend across the margins of one vessel vascular territory into another, but can be treated with a single therapy are reported...
