Coding Resource Center
August 2023
After being delayed multiple years and completing five rounds of testing, the Centers for Medicare and Medicaid Services (CMS) will begin deploying validation edits for providers with multiple service locations beginning August 1, 2023. There are an increasing number of hospitals which operate off-campus, outpatient, provider-based departments of the hospital. Since there is the possibility […]
CPT Reporting for IBE with Main Aortic Trunk Question: What CPT® code should be reported for placement of an iliac branched (bifurcated) endograft when EVAR includes both a main trunk and an iliac branched endograft during the same surgical session? Answer: Code +34717 should be reported: Endovascular repair of iliac artery at the time of […]
TEVAR Criteria Question: What is the main criteria used to determine the primary procedure code for the TEVAR procedure? Answer: Based on the code descriptions, the main criteria used to determine the primary procedure code for the TEVAR procedure is whether the endoprosthesis is covering the subclavian artery origin or not. TEVAR Extension Prosthesis Question: […]
Question: What services does a percutaneous transcatheter closure of ASD/PFO include? Answer: Per CPT® guidelines, code 93580 includes a right heart catheterization (codes 93451-93453, 93455-93461, 93530-93533) and injection procedure for atrial and ventricular angiography (93564-93566) when performed. These codes should not be reported separately.
Dialysis Circuit Procedures Question: What is the dialysis circuit and how are procedures for this structure reported? Answer: According to CPT® guidelines, the arteriovenous (AV) dialysis circuit is a surgically created structure designed for easy long-term access for hemodialysis. It can either be an AV fistula (AVF) or AV graft (AVG). It begins at the […]
Multiple Hernias through single incision Question: When multiple hernias are repaired through the same incision, is one code or multiple codes assigned? Answer: According to AHA Coding Clinic for HCPCS, First Quarter 2020, assign one hernia repair code only as recommended in the most current advice published in Coding Clinic for HCPCS, Third Quarter 2016. […]
CERAB Procedure Question: What is the CERAB procedure and how is it reported? Answer: CERAB (covered endovascular reconstruction of aortic bifurcation) is a technique used in the treatment of aorto-iliac occlusive disease. It consists of a covered stent in the aorta, and one covered stent in each of the common iliacs that cover the bifurcation, […]
DIPS Procedure Question: What is the appropriate CPT® code for a Direct Intrahepatic Portacaval Shunt (DIPS) procedure? Answer: According to CPT® Assistant September 2013, the DIPS procedure should be reported with the same code as a Transvenous Intrahepatic Portosystemic Shunt (TIPS) procedure, code 37182 [Insertion of transvenous intrahepatic portosystemic shunt(s) (TIPS) (includes venous access, hepatic and portal vein catheterization, portography with hemodynamic evaluation, intrahepatic tract […]
Stenting of Popliteal Aneurysm Question: What would the appropriate CPT® code for stenting of a popliteal aneurysm? Answer: Per Clinical Examples in Radiology Spring 2016, code 37236 (Transcatheter placement of an intravascular stent(s) (except lower extremity artery(s) for occlusive disease, cervical carotid, extracranial vertebral or intrathoracic carotid, intracranial, or coronary), open or percutaneous, including radiological supervision and interpretation and […]
Covered Graft Question: What is the difference between a covered graft and an endoprosthesis? Answer: From a coding perspective, there is no difference. CPT® guidelines specify the terms endovascular graft, endoprosthesis, endograft and stentgraft all refer to a covered graft. Drug-coated vs Drug-eluting Question: What is the difference between a drug-coated stent and a drug-eluting […]
