Is there a CPT code for suture placement to stop the bleeding of a pyogenic granuloma? Any help would be greatly appreciated.
Click here for more sample CPC practice exam questions with Full Rationale Answers
Laureen shows you her proprietary “Bubbling and Highlighting Technique”
Download your Free copy of my "Medical Coding From Home Ebook" at the top right corner of this page
Tag Archives: Placement
EGD w/BX and Pillcam Placement
Our provider delivered Pillcam with EGD scope but he also took biopsies from esophagus. I billed 91110/26 and 43239, this was done as outpt procedure
in hospital. BCBS Fl has denied 43239 stating it is bundled with 91110/26. I know that somewhere I have read that if biopsies are taken that the 43239 is
a separate procedure and is billable and is not bundled. I need to write an appeal letter but can’t find and specific guidelines stating that fact. Can any one one
direct me to a source that would clarify that is bx taken the 43239 is payable. I need to make copies so that I can attached to the appeal letter.
We have Super Coder, can find nothing there and I have also looked on AAPC coding forum. Please help me because the insurance can’t get away
with bundling and not paying the 43239. Thanks you
in hospital. BCBS Fl has denied 43239 stating it is bundled with 91110/26. I know that somewhere I have read that if biopsies are taken that the 43239 is
a separate procedure and is billable and is not bundled. I need to write an appeal letter but can’t find and specific guidelines stating that fact. Can any one one
direct me to a source that would clarify that is bx taken the 43239 is payable. I need to make copies so that I can attached to the appeal letter.
We have Super Coder, can find nothing there and I have also looked on AAPC coding forum. Please help me because the insurance can’t get away
with bundling and not paying the 43239. Thanks you
Turn to 0438T for SpaceOAR® System Supply and Placement
In July 2016, the American Medical Association (AMA) introduced CPT® Category III code 0438T Transperineal placement of biodegradable material, peri-prostatic (via needle), single or multiple, includes image guidance. The code subsequently was included in the 2017 CPT® codebook. Code 0438T describes the supply and placement of a temporary, biodegradable implant, marketed as the SpaceOAR® System […]
AAPC Knowledge Center
Bladder Tumor Resection and Ureteral Stent placement
Can someone please offer guidance?
My provider performed transurethral resection of bladder tumor that invaded the ureteric orifice. He inserted a stent to "facilitate drainage".
NCCI Edits bundle the two procedures together, is it appropriate to unbundle them in this scenario?
My provider performed transurethral resection of bladder tumor that invaded the ureteric orifice. He inserted a stent to "facilitate drainage".
NCCI Edits bundle the two procedures together, is it appropriate to unbundle them in this scenario?
"The patient had a large, approximately 3-4 cm papillary bladder tumor on his right lateral wall, obscuring the identification of his right ureteral orifice. This was resected sequentially down to muscle. The right ureteral orifice was identified and it was not the source of the tumor, but did appear to have some involvement of papillary tumor at the orifice. The right ureteral orifice was resected and sent as a separate pathologic specimen. Given the resection, we placed a ureteral stent on this side to facilitate drainage and also assist future resections."
52332-59-RT
52335
Thanks in advance…
ERCP-multiple stents exchanged with one new placement
Hello there,
We have a case where 5 stents were exchanged in the common bile duct along with one new stent. So, a total of 6 new stents were placed. How should this be coded since it was all in the common bile duct? 43276×5 or 43274×6?
Thanks for your help!
Aborted pacemaker placement
Hi, I could use some advice on this please. Would you bill this as a pacemaker placement 33207 with a 53 modifier along with a Venography? I appreciate the info.
PROCEDURE: Venogram was done on the right and left side-patent venous system was confirmed. The patient was prepped and draped in the usual sterile fashion. Access was gained into the left axillary vein after venography and fluoroscopy-first with a micropuncture wire and then with a regular wire. Right sided placement was confirmed after passing the wire below the diaphragm. The prior incision (made at the outside hospital was opened). The two wires were brought out of the incision.
**
The ventricular lead was advanced directly via a 7 Fr long sheath and positioned in the right ventricular mid septum under fluoroscopy. Lead characteristics were measured and were satisfactory. After I split the sheath there was copious bleeding seen. These occurred to have an arterial pulsation and were seen around the lead as well as in an area more lateral and inferior to the lead. I placed several purse-string sutures around the lead and cauterized other areas that appeared to be bleeding. Hemostasis could not be achieved.
*
I finally called the cardiac surgeons, who also placed purse string sutures around the lead with no effect.
*
After a long discussion about possible causes, that included damage to an arterial branch around the vein, or the main axillary artery itself, I decided to pull out the lead. Hemostasis was finally obtained by manual compression with gauze. Using a staged approach, compression was gradually released and hemostasis was confirmed. The wound was closed by the surgeon-please see his note for details.
Ureteroscopy with laser lithotripsy and stent placement question
I think I am correct on this, but I just want to double check.
Urologist did a cystoscopy with right ureteroscopy and laser lithotripsy, with bilateral stents placed. Am I correct to code this as 52356-RT and 52332-59LT? My reasoning is that only the stents are bilateral; the ureteroscopy and laser litho were right-sided only.
Thanks!
A-line Placement Documentation Question
Does the end time need to be documented for 36620? Or just the start time?
Hemicraniectomy for Placement of Frontal External Ventricular Drain
I was hoping to get some advice on an op note I’m working on. I’m going between 2 codes.
[I]PREOPERATIVE DIAGNOSIS: Right hemisphere cerebral edema
**
POSTOPERATIVE DIAGNOSIS: Same
**
PROCEDURES: Right Hemicraniectomy
Placement of right frontal external ventricular drain
Use of intraoperative ultrasound
**
INDICATIONS: Joyce Irene Wittenborn is a pleasant 65 y.o. with a history of a brain abscess which we evacuated 2 nights ago. She initially was neurologically stable, but declined today. A repeat CT scan was performed demonstrating a marked increase in the degree of cerebral edema surrounding her evacuated abscess. The patient was taken emergently to the OR for decompression.
PROCEDURE IN DETAIL: The patient was brought to the OR and placed under general anesthesia and then positioned supine on the operating table with his head affixed in a Mayfield headrest in reverse Trendelenburg position. The ipsilateral side of the head pre-prepped with alcohol, and then a small strip of hair clipped and a question mark style incision incorporating the inferior half of her previous linear middle fossa incision was drawn out and infiltrated with 1% lidocaine with epinephrine. The entire area was prepped with ChloraPrep and draped off in sterile fashion. A time out was performed. The patient was already receiving multiple IV abx.
**
The scalp incision was opened and Raney clips used then the scalp was retracted using elastic hooks and a Layla bar. Burr holes were placed then a large hemicraniectomy performed with a craniotome. Strict epidural hemostasis was achieved then the dura opened in flap fashion. Onlay surgicel was used. Surgicel and suprafilm were placed under the exposed temporalis. Using intraoperative ultrasound, a right frontal antibiotic impregnated EVD was placed to a depth of 6.5 mm with spontaneous egress of csf under mild to moderate pressure. A 10mm flat JP drain placed subdurally and tunneled posteriorly. The scalp was closed in standard fashion using Vicryl followed by Vicryl Rapide.The wound was dressed in sterile fashion. There were no apparent complications during the case.
*
Usually when drains are placed they only perform burr holes but he does burr holes along with a hemicraniectomy.
I was wondering if I should just go ahead and use the burr holes for EVD placement (61210) or would Craniectomy for drainage of intracranial abscess (61320) be more appropriate?
The patient does have a history of a brain abscess and then ended up developing a cerebral edema around it.
I just want to make sure that Im using the best code for this situation.
Thanks in advance for any help!
Ct needle placement for embolization of aaa
How would I code for the placement of these needles into the edge of the aneurysm sac prior to embolization?
CT Abd/pelvis with IV was done confirming the presence of a type II endoleak. From a left posterior paraspinal approach employing CT fluoro a 17-guage guiding needle was advanced to the edge of the aneurysm sac having a trajectory expected to enter the endoleak. From a more lateral approach a second 17-guage guiding needle was advanced to the edge of the sac having a trajectory expected to enter the sac in a slightly different location. The patient was then transferred to the angiographic suite where the direct sac emboliaztion was subsequently performed which will be separately reported.
Is there a code for the placement of both needles?
Thanks,