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Cineangiography and Fluoroscopy – Need Help Please
PROCEDURE: Cineangiography and fluoroscopy.
INDICATION: A 63-year-old with a history of a mechanical valve. By record, she has a Medtronic Hall single leaflet valve.
DESCRIPTION OF PROCEDURE: The patient was placed on the cath table and fluoroscopy was used to angulate the valve in a short and long axis view. All views demonstrated normal appearance of the valve with zero closing angle and approximately 75-degree opening angle. There was no evidence of restriction. Additionally, cineangiography of the diaphragm was obtained using deep breaths and showed normal motion of both left and right hemidiaphragms.
CONCLUSION: Normal cineangiography of the mechanical aortic valve.
Fluoroscopy coding in physician office
He was also using this code while performing an injection. I believe the correct cpt for the use of the fluoroscopy during the injection is 77002 which be the additional code to the injection code. However when the provider does the Fluoroscopy just for diagnostic purposes to view the joint of the hand I believe he should be using 76942, the unlisted fluoroscopy code.
The company that sold him the machine told him to code 76000. Or should the physician be using an x-ray code to describe what he did, as he has no x-ray machine in his office.
Any help would be greatly appreciated.
Thanks
:confused:
Jen
Fluoroscopy with a TEE
TEE was performed first in the cath lab because the provider knew going into the TEE that he will need to do Fluoroscopy.
I am unsure if i would bill it because when I think of Fluoroscopy i feel that it falls under image and guidance procedure and with a TEE imaging and guidance is included with the TEE CPT code.
Scenario: Provider knows going into the TEE that he will need to do Fluoroscopy.
CONCLUSION OF THE TEE:
Normal LV systolic function and wall motion with EF 60%.
Mild MR.
The bileaflet mechanical aortic valve prosthesis has leaflets that are somewhat difficult to visualize, but at least the more posterior leaflet appears to be moving normally. There is a very eccentric jet of paravalvular aortic insufficiency that arises posteriorly and tracks directly across the LVOT just under the valve and is at least moderate to severe. It is brought in the LVOT but does not penetrate deep into the ventricle, possibly because of its eccentricity. I can’t completely rule out that there might also be some valvular AI coming through the more anterior leaflet, but I think this appearance is caused by deflection of the eccentric paravalvular jet under the valve. I also note that there is a thin, echogenic rigid appearing structure above the valve posteriorly in the noncoronary sinus of Valsalva, which may represent a line of pannus ingrowth, suture, or some other structure. It looks almost like a strut of a bioprosthetic valve, but this is a strutless mechanical valve.
Trace TR.
Mild pulmonic insufficiency.
No patent foramen ovale.
No left atrial appendage thrombus.
Mild intimal thickening of the descending thoracic aorta.
Mildly dilated mid ascending aorta measuring 4.1 cm in diameter.
Thank you
ERCP fluoroscopy
Ganglion Impar Block with Fluoroscopy
Can someone please advise on the correct code for Ganglion Impar Block with Fluoroscopy.
Thank you.
Fluoroscopy Billing
Thank you for any input…
Intraoperative Fluoroscopy
Provider performed a close reduction right ankle with application of external fixator for a right ankle pilon fracture. In the operative report,…
Medical Billing and Coding Forum
Capture Elements of Spinal Injections and Fluoroscopy
In 2015, the CPT® codebook separated joint injections and aspirations into services “with” and “without” image guidance. This year, CPT® has taken a similar approach with spinal injection services. As of Jan. 1, 62310-63219 are deleted, and replaced with: 62320 Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antis
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