This page addresses follow-up questions and additional information pertinent to our webinar
Exploring Vascular Surgery Coding.
** 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: When a composite graft is performed using an in-situ vein along with a synthetic graft, assign a code from code range 35600-35671 for the synthetic graft and a second code for the in-situ graft from code range 35583-35587.
A: Per the 2024 Medicare Physician Fee Schedule, CPT code 36830 (Creation of arteriovenous fistula by other than direct arteriovenous anastomosis; nonautogenous graft) has a co-surgery indicator of 1, indicating co-surgeons could be paid. Supporting documentation is required to establish the medical necessity of two surgeons for the procedure and the two surgeons should each be in a different specialty. They would each bill code 36830 and append modifier 62. Unfortunately, Code 36558 has a co-surgeon indicator of zero (not permitted), so whoever physically placed the central line can report code 36558. If the central line was placed using radiological guidance, the radiological supervision and interpretation may be billed separately (e.g. 77001, 76937) if documentation requirements for those codes are met.
A: Per the Medicare PFS, code 35301 has a 90-day global so if a redo is required before 30 days, that would normally be considered a complication. In that case Medicare guidance allows the repeat trip to the OR to be reported with a modifier. For example, 35301-78 (unplanned return to the OR by the same provider for a related procedure within the post-op period). Code 35390 has a global of ZZZ indicating it is related to another service (35301) and is included in the global period of that service (35301). For facility, this is an inpatient-only procedure that is reported using ICD-10-PCS codes rather than CPT codes.
Looking for additional information on this topic?
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