November 30, 2023 Question: When a provider preforms less than 10 stab phlebectomies what is the comparison code? Answer: I would recommend using CPT 37999 for the stab phlebectomies. Make sure you are looking at the providers documentation as it depends on the number of incisions the providers make. *This response is based on the...
November 2, 2023 Question: How often can you use the add on codes for mechanochemical ablation of varicose veins? Answer: Use add-on code(s) 36474,36476, 36479 or 36483 for additional veins ablated through separate access sites of other truncal veins in the same leg. Only report add on code ONCE regardless of the number of additional...
November 2, 2023 Question: Is it best practice to bill 99202-99215 based on time only? Answer: CPT codes 99202 to 99215 no longer require that the History and Examination be key factors in determining the level of Evaluation and Management (E/M) code. Instead, the E/M code is dependent on: • Level of Medical Decision Making...
October 19, 2023 Question: How is the TCAR procedure reported? Answer: Transcarotid Artery Revascularization (TCAR) is a minimally invasive procedure that can clear blockages and open a narrowed cervical carotid artery. The surgeon makes an incision over the common carotid artery to perform the repair. During the TCAR procedure, the surgical team reverses blood flow in...
October 5, 2023 Question: What does Medicare consider high risk to support a stent instead of a carotid endarterectomy (CEA)? Answer: Patients at high risk for CEA are defined as having significant comorbidities and/or anatomic risk factors (i.e., recurrent stenosis and/or previous radical neck dissection) and would be poor candidates for CEA in the opinion...
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...
