More Reductions in Reimbursement for Vascular Access Procedures from Medicare
Vascular Access
Endovascular procedures will see further reductions in reimbursement that started in 2007 and will continue into 2010. This may pose a challenge for vascular access facilities that are owned and operated independently. Facilities that are owned by physicians will continue to absorb any reduction in technical components through the professional portion.
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*Transluminal balloon angioplasty, percutaneous |
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CPT Code |
Description |
|
35470 |
Tibioperoneal trunk or branches, each vessel |
|
35471 |
Renal or visceral artery |
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35473 |
Iliac |
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35474 |
Femoral-popliteal |
|
35475 |
Brachiocephalic trunk or branches, each vessel |
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35476 |
venous |
*Above codes do not include the imaging procedures.
Links:
http://www.evtoday.com/PDFarticles/0704/et0704sf2_Ross.pdf
http://www.renalmd.org/documents/2010NPRMCOM8-31-2009FINAL.pdf
http://www.vpico.com/articlemanager/printerfriendly.aspx?article=250490
Coding for Mifepristone/Misoprostol Abortion (RU486)
Each
insurance company is different, review the following this link (Mifeprex) to find which codes you should bill, however, here is the most common:
Visit 1: Includes verification of pregnancy and pregnancy date, counseling of the patient, and administration of mifepristone
Diagnosis code 635.92 (legally induced abortion, without mention of complication, complete). Please check ICD-9 manual for other codes for abortion with complications). Five-digit diagnosis code needed.
99204 or 99214 (level 4 new or established patient E/M visit)
J8499 (prescription drug, oral, nonchemo, not otherwise specified) or
J3490 (unclassified drug). If J codes are not accepted by insurance carrier, use 99070 (a cost of materials CPT code) or S0190 for Mifepristone. Each insurance carrier may reimburse for mifepristone using a different code. The name of the drug (mifepristone), the dosage (200 mg.), and the 11-digit national drug code (NDC) from the drug package must accompany this claim. In addition, submit a copy of the drug invoice to show the cost of the drug.
76817 (transvaginal ultrasound, pregnant uterus) or 76815 (limited ultrasound, pregnant uterus)
In addition, submit codes for appropriate lab tests or Micro Rhogham (90385) if done in office.
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Visit 2: Verifies that the pregnancy has ended.
Diagnosis code 635.92
99213 or 99214 (level 3 or 4 E/M visit for established patient)
76817 or 76815 (ultrasound)
More Specific Policy:
How to code for abortions, CPT Codes: 59820, 59821, 59840, 59841, 59850, 59851, 59852, 59855, 59856, 59857, 59870, 59200
Common Descriptions:
| 59840 | Induced abortion, by dilation and curettage |
| 59841 | Induced abortion, by dilation and evacuation |
| 59850 | Induced abortion, by one or more intra-amniotic injections (amniocentesis-injections), including hospital admission and visits, delivery of fetus and secundines |
| 59851 | Induced abortion, by one or more intra-amniotic injections (amniocentesis injections), including hospital admission and visits, delivery of fetus and secundines; with dilation and curettage and/or evacuation |
| 59852 | Induced abortion, by one or more intra-amniotic injections (amniocentesis-injections), including hospital admission and visits, delivery of fetus and secundines; with hysterotomy (failed intra-amniotic injection) |
| 59855 | Induced abortion, by one or more vaginal suppositories (e.g., prostaglandin) with or without cervical dilation (e.g., laminaria), including hospital admission and visits, delivery of fetus and secundines |
| 59856 | Induced abortion, by one or more vaginal suppositories (e.g., prostaglandin) with or without cervical dilation (e.g., laminaria), including hospital admission and visits, delivery of fetus and secundines; with dilation and curettage and/or evacuation |
| 59857 | Induced abortion, by one or more vaginal suppositories (e.g., prostaglandin) with or without cervical dilation (e.g., laminaria), including hospital admission and visits, delivery of fetus and secundines; with hysterotomy (failed medical evacuation) |
| 59870 | Uterine evacuation & curettage for hydatidiform mole |
59820 – Missed abortion 1st trimester
59821 – Missed abortion 2nd trimester
Other potential add on CPT codes are: 76815 (Sonogram/Ulstrasound), 93000 (EKG), 36415 (Venipuncture), 85019 (hemoglobin), and 81025 (pregnancy test)
For Laminaria procedures:
CPT Codes: 59857, 59200 (separate procedure - usually the second day), 88300 (surgical pathology), 76815 (Sonogram/Ultrasound)
Here are links to insurance company policy and other sources:
CPT code for standard phacoemulsification with intraocular lens implant? CPT Code 66982
Clients often ask coding questions, here is a great one, do you happen to know the CPT code for standard phacoemulsification with intraocular lens implant?
Coding for Complex Cardiac Surgery: CPT Codes 66982, 67005, 67010, 66850-52
Great Article: http://www.eyeworld.org/article.php?sid=3773
