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6 Step Successful Coding for Endovascular AAA Repair

6 Step Successful Coding for Endovascular AAA Repair. Presented by Lori Dafoe, CPC. DON’T PANIC!. Resources. CPT Chapter Notes CPT Assistant Articles Laminated, color coded vascular charts Medlearn/Panacea Medical Asset Management National Correct Coding Initiative (NCCI) Edits

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6 Step Successful Coding for Endovascular AAA Repair

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  1. 6 Step Successful Coding for Endovascular AAA Repair Presented by Lori Dafoe, CPC

  2. DON’T PANIC!

  3. Resources • CPT Chapter Notes CPT Assistant Articles • Laminated, color coded vascular charts Medlearn/Panacea Medical Asset Management • National Correct Coding Initiative (NCCI) Edits • Vascular Web • Excellent physician documentation!

  4. Step #1: Is this an endovascular repair, or an open repair? • If the documentation records an open surgery directly at the aneurysm site, see CPT 35001-35152 to report.

  5. Example of Open Repair

  6. STEP #2:Was there open surgical exposure of an artery? • Femoral Artery: 34812 • Femoral Artery (Bilateral): 34812-50 • Iliac Artery (Unilateral): 34820 • Iliac Artery (Bilateral): 34820-50

  7. Example of Open Femoral Artery Exposure: CPT 34812

  8. Example of Open Iliac Artery Exposure: CPT 34820

  9. STEP #3: What catheters were introduced into the aorta or aortic branches? • Aorta alone (no selective catheterization): 36200 • Aorta Bilateral (Identifies accessing aorta via both legs): 36200-50 • Aorta + 1St Order Vessel (eg, renal artery) via different access points (Both legs): 36200 and 36245

  10. STEP #4: What type of device was used for the repair? • Tube: 34800 • Modular Bifurcated: 34802 • Unibody Bifurcated: 34804 (Note: Only one of these codes should be reported.)

  11. Tube Prosthesis: CPT 34800

  12. Unibody Bifurcated Prosthesis: CPT 34804

  13. STEP #5: Were other separately reportable services provided? Examples include: • S&I for Repair: CPT 75952 • Extension Cuffs: CPT 34825 and +34826 • S&I for extension cuffs: CPT 75953 • Balloon angioplasty outside endograft: 35473 or 35454 35471 or 35450 • Arterial Occlusion or Embolization: 37204

  14. Extension Cuffs: CPT 34825/34826 Aortic Extender Iliac Extender

  15. Step #6: Was the endovascular repair converted to an open procedure? • Tube prosthesis: CPT 34830 • Aorto-bi-iliac prosthesis: CPT 34831 • Aorto-bifemoral prosthesis: CPT 34832

  16. 6 Step Review • Step #1: Is this an endovascular repair, or an open repair? • Step #2: Was there open surgical exposure of an artery? • Step #3: What catheters were introduced into the aorta or aortic branches? • Step #4: What type of device was used for the repair? • Step #5: Were other separately reportable services provided? • Step #6: Was the endovascular repair converted to an open procedure?

  17. LET’S PRACTICE CODING!

  18. RESOURCES:CPT Assistanthttp://www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/cpt.pageMedlearn/Panaceahttp://shop.medlearn.comMedical Asset Managementhttp://www.medicalassetsmanagement.com/Illustrations/illustrations.htmlNCCI Editshttp://www.cms.gov/Medicare/Coding/NationalCorrectCodInitEd/index.html?redirect=/NationalCorrectCodInitEd/NCCIEP/list.aspVascular Webhttp://www.vascularweb.org/Pages/default.aspx

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