Coding Resource Center
September 2023
CMS has launched a new version of their website that features an updated information format and simplified navigation options, as well as a “refreshed” home page. This change came about as a result of stakeholders providing input for improvements to the website. CMS is asking the public to visit the updated website and provide feedback […]
August 2023
On August 1, 2023, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that updates Medicare payment policies for hospitals under the Inpatient Prospective Payment System (IPPS) for fiscal year (FY) 2024. Once these polices become final, they will cover inpatient hospital discharges on or after October 1, 2023. Highlights are described […]
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 […]
