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Renal Artery stenting
Our doctor did a AAA repair and a right renal artery PTA and stenting. I used codes 34705, 34713 and 37236. I am getting a rejection back on 37236. Is there another code I should be using?
Thanks
Chronic renal insufficiency w/ inproved/stable blood work
Please help! Is this renal billable?
Two-vessel coronary artery disease
Severe in-stent restenosis within mid RCA
Positive FFR of RCA
Successful cutting balloon angioplasty to mid RCA with 3.0 x 10 mm Wolverine balloon
Elevated LV filling pressure
Abdominal aortography with runoff showing no severe renal artery stenosis and no significant PAD in the aortoiliac system
Coronary Findings
Diagnostic
Dominance: Right
Left Main
The left main was selectively engaged with a catheter and visualized by angiography. Other findings: Large caliber vessel that is angiographically normal..
Left Anterior Descending
The LAD was visualized by angiography. Other findings: Medium to large caliber vessel proximally with a ledge-like 30-40% proximal stenosis. The mid to distal vessel has diffuse luminal irregularities but no area of critical stenosis. The first diagonal is a sizable branching vessel that has mild luminal irregularities but no critical stenosis..
Left Circumflex
The circumflex was visualized by angiography. Other findings: Medium to large caliber vessel with a 20-30% proximal stenosis. The mid stent is patent with 20-30% in-stent restenosis. OM1 is angiographically normal..
Right Coronary Artery
The RCA was selectively engaged with a catheter and was visualized by angiography. Other findings: Medium to large caliber dominant vessel with a proximal 20-30% stenosis. There is a patent stent in the mid vessel (2 layers) with 60-70% in-stent restenosis proximally and 50-60% in-stent restenosis distally. The RPDA is small with mild ostial disease. The RPL has a patent proximal stent with 30-40% in-stent restenosis that appears stable from prior angiograms. There are 2 branches to the RPL that have mild luminal irregularities..
Mid RCA lesion is 70% stenosed. This is the culprit lesion. The lesion is not complex (non high-C). The lesion was previously treated using a drug-eluting stent. Previous treatment took place 1-2 years ago. There is in-stent restenosis. There is no in-stent thrombosis. The stenosis was measured using by visual assessment.
Intervention
Mid RCA lesion
POBA
Guide catheter used: CATH GUIDE 6F FR4 BOSTON SCI.Guidewire that crossed the lesion: GUIDEWIRE PROWATER .014"X180CM STRAIGHT PTCA ASAHI INTECC. Angioplasty using a scoring balloon was performed. The balloon used was a CATHETER BALLOON CUTTING 3.00X10MM WOLVERINE BOSTON. Maximum pressure: 12 atm. Comments: Inflated both proximally once and distally once within previously placed stent.
Post-Intervention Lesion Assessment
There is no residual stenosis post intervention.
Left Heart
Left Ventricle LV end diastolic pressure is moderately elevated and was measured at 30 mmHg. Comments: Abdominal aortography with runoff: Abdominal aorta is patent. Left renal artery has a 30% proximal stenosis. Right renal artery is patent with no significant stenosis. Bilateral common iliac, bilateral internal iliac, and bilateral external iliac arteries are patent with no significant stenosis. Bilateral common femorals are patent with no significant stenosis..
Renal disease and HTN
renal disease=N28.9
hypertension=I10
:confused:
Follow up renal Ultrasound on 40 days old infant
A 40 day old infant was ordered a Renal ultrasound as a follow up on her abnormal prenatal US as they showed kidney dilation. We got a denial as we used O28.3 which should go on mothers records but not on an infant’s. Of course, we realized after the denial. The new born does not show any signs or symptoms to reorder this US for us to code and the intention is purely for re screening as per the order.
P.S- P09_Abnormal findings on neonatal screening was actually coded on the initial birth claim.
What would be appropriate diagnosis code to code in this scenario. Thank you!
Followup renal Ultrasound on 40 days old infant
A 40 day old infant was ordered a Renal ultrasound as a followup on her abnormal prenatal US as they showed kidney dilation. We got a denial as we used O28.3 which should go on mothers records but not on an infant’s. Of course, we realized after the denial. The new born does not show any signs or symptoms to reorder this US for us to code and the intention is purely for re screening as per the order.
P.S- P09_Abnormal findings on neonatal screening was actually coded on the initial birth claim. What would be appropriate diagnosis code to code in this scenario. Thank you!
Dx for renal entero fistula
I am not finding any ICD 10 code that I feel is appropriate for the above. I have been led to K63.2 as well as N28.89 but neither of which I am sure whether they are the correct diagnosis code.
Anyone have any input on this topic?
TIA
KAM
Hyperparathyroidism of renal origin
outpt acute renal failure converted to esrd in same month billing
..pt is billed 90935 on two separate days in august for acute renal failure as an outpt.
..pt is now declared ESRD at the end of the month and md provides a complete comprehensive visit, 90962
can I bill all three charges: 90935 x2, and 90962?
or can I now only bill the comprehensive visit 90962?
:confused:
thx for any opinions