This page addresses follow-up questions and additional information pertinent to our webinar
Getting Through the OP Report without Crying: Arterial Revascularization.
** The coding information and guidance are valid at the time of publishing. Learners are encouraged to research
subsequent official guidance in the areas associated with the topic as they can change rapidly.
A: Coverage criteria for carotid stenting can be found in NCD 20.7 (Angioplasty). This policy clarifies that carotid artery stenting is covered for Medicare beneficiaries when an FDA-approved or cleared embolic protection device (EPD) is used for the following conditions:
- Symptomatic carotid artery stenosis ≥ 50%
- Asymptomatic carotid artery stenosis ≥ 70%
Q: For carotid stenting, if embolic protection was attempted but could not be used and the provider proceeded without it, can code 37215 be reported with a modifier for reduced services?
A: No. If embolic protection cannot be used, code 37216 (carotid artery stenting without embolic protection) should be reported. It is inappropriate to report 37215 with a modifier for reduced services, even if embolic protection was attempted.
Q: What criteria must be met to report code 76937 for ultrasound-guided vascular access?
A: To report CPT 76937, ultrasound guidance for vascular access must include all of the following:
- Ultrasound evaluation of potential access sites
- Documentation of selected vessel patency
- Concurrent real-time ultrasound visualization of vascular needle entry
- Permanent recording and reporting (PACS)
Q: In the lower extremities, if a complex lesion was treated with angioplasty and stenting and a straightforward lesion was treated with atherectomy in separate vessel of the same vascular territory, what is the base procedure?
A: The progressive hierarchies determine the base procedure. In this situation, code atherectomy of the straightforward lesion and use an add-on code for stenting of the complex lesion.
Meet the Presenter: Kristi Pollard, RHIT, CCS, CPC, CIRCC
Kristi is the Director of Coding Quality & Education with more than 25 years of industry experience; she is responsible for the development of web-based, instructor-led, and webinar training materials; conducting training in ICD-10-CM/PCS and CPT; and performing DRG and APC audits. Kristi has an extensive background in coding education and consulting and is a national speaker and published writer on topics related to ICD-10 and CPT coding and code-based reimbursement. She has designed and developed training programs for inpatient and outpatient hospital-based coding, with a focus on vascular interventional radiology, interventional cardiology, orthopedics, and obstetrics.
0 Comments