Vascular Catheterization

Vascular Catheterization - Coding

Vascular system anatomy and terminology to make reporting these procedures less challenging.

A thorough understanding of the anatomy and medical terminology of the vascular system is required to accurately code arterial vessel procedures. Here’s a quick run-through of clinical information and coding guidance to show you how order affects coding.

Order Matters

Please refer to Appendix L of the CPT® code book for the vascular families.

The aorta is the major artery. Each main vessel branching off the aorta is a first order vessel (e.g., left common carotid).

First order vessels have several vessels branching off them, designated as second order vessels (e.g., right subclavian and axillary).
Second order vessels have several vessels branching off them, designated as third order vessels (e.g., right internal carotid).
Third order vessels have several smaller vessels branching off them, designated as beyond the third order (e.g., left deep palmar arch).

Catheterization Can Either Be Selective or Non-Selective

For selective catheterization, the catheter is manipulated into other branches of the vascular family. Coding is based on the most distal vessel into which the catheter is placed.

For non-selective catheterization, the catheter is not manipulated or advanced into other branches of the vascular family.

The procedure for arterial catheterization typically begins with the placement of the catheter into the aorta. If the catheter is not manipulated or advanced into any other vessel beyond the aorta, report the procedure using:

36200 Introduction of catheter, aorta

First Order Vessels

If the catheter is placed in any first order vessel and it is not advanced beyond any other vessel, report the procedure using either:

36215 Selective catheter placement, arterial system; each first order thoracic or brachiocephalic branch, within a vascular family

or

36245 Selective catheter placement, arterial system; each first order abdominal, pelvic, or lower extremity artery branch, within a vascular family

The descriptions of these two codes divide the arterial system into two parts.

Second Order Vessel

If the catheter is manipulated or advanced from the first order vessel into the second order vessel but not beyond, report the procedure using either:

36216 Selective catheter placement, arterial system; initial second order thoracic or brachiocephalic branch, within a vascular family

or

32646 Selective catheter placement, arterial system; initial second order abdominal, pelvic, or lower extremity artery branch, within a vascular family

First vessel catheterization is not reported because only the highest order catheter placement is reported for selective catheterization.

Third Order Vessels

If the catheter is manipulated or advanced into a third order vessel or beyond, report the procedure using either:

36217 Selective catheter placement, arterial system; initial third order or more selective thoracic or brachiocephalic branch, within a vascular family

or

36247 Selective catheter placement, arterial system; initial third order or more selective abdominal, pelvic, or lower extremity artery branch, within a vascular family

Report additional catheter placements beyond a third order placement using:

+36218

Selective catheter placement, arterial system; additional second order, third order, and beyond, thoracic or brachiocephalic branch, within a vascular family (List in addition to code for initial second or third order vessel as appropriate) Selective catheter placement, arterial system; additional second order, third order, and beyond, abdominal, pelvic, or lower extremity artery branch, within a vascular family (List in addition to code for initial second or third order vessel as appropriate)

and

+36248

Do not use these codes when additional first order vessels are catheterized. Instead, report additional units of the codes describing first order vessel catheterization.

Comments

Revenue Cycle Management - RCM

When you enter the field of US Healthcare, the first thing you notice right away is the unique terminology that keeps bombarding you! New medical terms and medical slang keep popping up. Added to it is the abbreviations, acronyms and what not.... You feel overwhelmed at first... But gradually with some patience you can master the terms which are used often in your office. I am listing below some common healthcare terms used in Insurance and Billing in RCM. Check them out and hope you will learn a word or two! BILLING TERMS When both you and your health insurance company pay for your health care expenses, it’s called cost sharing. Deductibles, coinsurance and copays are all examples of cost sharing. Understanding how they work will help you know how much you’ll pay. Deductible A deductible is the amount you pay for health care services before your health insurance begins to pay. How it works: If your plan’s deductible is $1,500, you’ll pay 100 percen

What is Medical Coding?

Medical coding is the transformation of healthcare diagnosis, procedures, medical services and equipment into universal medical alphanumeric codes.” Put simply, this refers to the process of translating important medical information into simple codes for the purpose of documenting medical records and informing accurate medical billing. There are a few different types of medical codes used in healthcare settings today, but each of them allows for uniform documentation between medical facilities. Having this standard system allows for a more seamless transfer of medical records and more efficient research and analysis to track health trends. The three main types of codes are ICD-10-CM, CPT-4, and HCPCS What is a medical coder? Medical coders are the individuals responsible for translating physicians’ reports into useful medical codes. These professionals work behind the scenes in a variety of settings, ensuring all pertinent information is coded appropriately to e

CPT Quiz - 40000 Series

Quiz created by Vijayarani Sivakumar with GoConqr

Allograft vs Autograft vs Xenograft

Allo – Same species Auto – Same person Xeno – Animal (different species) An autologous transplant uses a person's own stem cells. ... In a reduced-intensity allogeneic transplant, doctors suppress the recipient's immune system enough so the donor stem cells can take root, or “engraft,” there. An autograft is a bone or tissue that is taken from a part of a person’s own body and transplanted into another. Often, surgeons will use a person’s own hamstring tendon to repair a damaged anterior cruciate ligament. Similarly, an autograft bone may be transplanted from a person’s hip to aide in a spinal fusion. Patients who undergo autograft procedures may experience increased postoperative pain from the second surgical (autograft) site. They may also require longer periods of rehabilitation. The use of allograft is advantageous because there is no second procedure required to remove and transfer a portion of the patient’s native bone or tissue. Surgical time may be

Necessity of English Proficiency in Medical Coding

Irish Blessing A moonbeam to charm you, A sheltering angel, so nothing can harm you. A sunbeam to warm you, Naturally, being fluent in English places you at an advantage in the field of Medical Coding. That being said, it does not fully eliminate you from entering Coding. Medical Coding is different from Medical Transcription and does not require the same expertise and fluency in English. Medical Transcription careers demand that you be highly fluent in American English, as we get most of our clients from the USA. You need to be tuned to their culture and lifestyle to name a few. But that is not the case with coding. Of course you should have a working knowledge of English. Or else you will be unable to comprehend a Medical Chart. As you need to peruse a medical chart, understand what is being done for a patient and derive the codes. The requirement for fluency in English is not as high as in Transcription. I keep comparing the two fields of transcription and coding becaus

Anatomy & Physiology Quiz

Quiz created by Vijayarani Sivakumar with GoConqr

Spleen - Anatomy

The spleen is an organ located in the upper left abdomen, and is roughly the size of a clenched fist. In the adult, the spleen functions mainly as a blood filter, removing old red blood cells. It also plays a role in both cell-mediated and humoral immune responses. The spleen in located in the upper left quadrant of the abdomen, under cover of the diaphragm and the ribcage – and therefore cannot normally be palpated on clinical examination (except when enlarged). It is an intraperitoneal organ, entirely surrounded by peritoneum (except at the splenic hilum). The spleen is connected to the stomach and kidney by parts of the greater omentum – a double fold of peritoneum that originates from the stomach: The spleen has a slightly oval shape. It is covered by a weak capsule that protects the organ whilst allowing it to expand in size. The outer surface of the spleen can be anatomically divided into two: · Diaphragmatic surface – in contact with diaphr

Place Holder X

The letter " x ” serves as a placeholder when a code contains fewer than six characters and a seventh character applies. The " x ” also allows for future expansion of the codes. When reporting ICD - 10 - CM codes, coders must add a placeholder so the seventh character is in the correct position. Not every ICD-10-CM code with a seventh character has a sixth character—or even a fifth or fourth character for that matter. This frequently occurs with poisonings and injuries. The letter "x” serves as a placeholder when a code contains fewer than six characters and a seventh character applies. The "x” also allows for future expansion of the codes. When reporting ICD-10-CM codes, coders must add a placeholder so the seventh character is in the correct position. Without this placeholder to ensure characters appear in the correct positions, codes are invalid. For example, a patient presents with an accidental poisoning by an antiallergic drug. For the initial

US Healthcare - Payment Posting

Payment posting and denial management are two extremely critical steps of the revenue cycle management of any solo practitioner or a healthcare organization. Streamlining these processes improves the RCM cycle leading to lesser delays in the A/R’s, ultimately guiding the way to increasing revenues along with patient satisfaction. Payment posting and its factors: In this process, the payment records of patients are recorded in the billing management software. It also includes attention to be given to claim denials — for identifying the problematic areas and their reasons along with apt actions to be taken on resolving the issues. Insurance Payment Posting: All payers either send an EOB (explanation of benefits) or ERA (electronic remittance advice) towards the payment of a claim. The medical billing staff posts these payments immediately into the respective patient accounts, against that particular claim to reconcile them. The payment posting is handled according to clie

Medical Coding, an excellent career choice!

As we are reeling under the pressure of COVID-19 infection in India, unemployment has reached sky high. Many have tried binge eating, binge cooking and binge watching movies to ward off boredom. So what is an alternative and viable option for our youngsters? Why not try something useful, that will enhance your career, or give a boost to your existing career. Learn something online. Be it a new skill, a new language, or something trending like Medical Coding. Medical Coding is a boon in such testing times. You can learn Medical Coding and re-skill yourself and reshape your career. If you are a graduate looking for an interesting and engrossing profession, Medical Coding checks all the boxes. The basic criteria needed is a college degree. Being tech savvy, which most of the youngsters are already thanks to smart phones, will help you move into this profession quite smoothly. A working knowledge of English is a must, as we receive all the work from USA. Once y

Medical Coding Simplified

Search This Blog