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Complete Guide for Interventional Radiology Page an In-Depth Guide to Interventional Radiology Coding, Billing and Reimbursement for Facilities and Physicians

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Complete Guide for Interventional Radiology Page an In-Depth Guide to Interventional Radiology Coding, Billing and Reimbursement for Facilities and Physicians 2019 Complete Guide for Interventional Radiology page An in-depth guide to interventional radiology coding, billing and reimbursement for facilities and physicians Sample Power up your coding optum360coding.com FIR_FIR19_CVR.indd 1 11/27/17 2:14 PM Contents Introduction ................................................................... 1 Transcatheter Endovascular Revascularization— CPT Codes and Descriptions ..........................................................1 Femoral/Popliteal Vascular Territory .......................... 123 Procedure Codes ..............................................................................3 Transcatheter Endovascular Chapter 1: The Basics ...................................................... 7 Revascularization—Tibial/Peroneal Vascular APC Basics–Why Is This Important? .............................................7 Territory ............................................................................. 126 CCI Edits–Why Is This Important? .............................................. 10 Endovascular Transluminal Angioplasty— Visceral and Recovery Audit Contractors (RAC) ............................................ 11 Brachiocephalic Arteries, Aorta, and the Coding Basics ................................................................................. 11 Venous System ................................................................. 129 General Coding Guidelines ......................................................... 12 Transluminal Atherectomy for Supra-Inguinal Arteries .... 136 Modifiers for Outpatient Hospital Radiology and Cardiology Transcatheter Stent Placement—Visceral and Procedures .......................................................................... 12 Brachiocephalic Arteries; Venous System ................. 140 Modifiers for Physician Services ................................................ 14 Revenue Codes .............................................................................. 18 Chapter 5: Neurovascular Interventions ..................... 147 General Interventional Radiology Coding Guidelines for Cerebral Endovascular Therapeutic Interventions ............. 147 Selective and Nonselective Catheter Placements ..... 19 Percutaneous Embolization—Cerebral (Extracranial Catheter Placement Codes for Interventional Radiology .... 20 and Intracranial) ............................................................. 150 General Cardiac Procedure Coding Guidelines ...................... 21 Temporary Balloon Occlusion .................................................. 155 Documentation .............................................................................. 22 Percutaneous Intracranial Angioplasty ................................ 157 Supply Device Codes .................................................................... 23 Transcatheter Vascular Stent Placement— Stark/Anti-Kickback Legislation ................................................. 23 Cervical Carotid ................................................................ 161 Stark Self-Referral Regulations .................................................. 23 Transcatheter Vascular Stent Placement—Intracranial ... 166 Chapter 2: Diagnostic Angiography .............................. 25 Transcatheter Vascular Stent Placement—Extracranial Cervicocerebral Angiography—Carotid and Vertebral or Intrathoracic Carotid Artery .................. 170 Vertebral Arteries .............................................................. 25 page Aorta Angiography—Thoracic and Abdominal .................... 31 Chapter 6: Vascular Access Device Placement Internal Mammary and Spinal Angiography .......................... 35 and Therapy ............................................................ 173 Non-Tunneled Vascular Access Device Placement ............. 174 Visceral Angiography—Celiac, Hepatic, Splenic, Inferior Phrenic, Superior and Inferior Mesenteric Tunneled Vascular Access Device Placement ...................... 177 Arteries, and Bronchial Arteries ..................................... 40 Repair/Replacement/Removal of Vascular Access Device 181 Renal Angiography ....................................................................... 48 Maintenance of Vascular Access Device ................................ 187 Adrenal Angiography ................................................................... 53 Chapter 7: Minor Interventional Procedures ............... 191 Extremity Angiography ............................................................... 56 Arthrography ............................................................................... 191 Pelvic Artery Angiography .......................................................... 60 Image-Guided Interventional Procedures— Pulmonary Artery Angiography ................................................ 64 Breast Biopsy .................................................................... 194 Image-Guided Interventional Procedures—Breast, Chapter 3: Diagnostic Venography ............................... 69 Other Than Biopsy ........................................................... 199 Cerebral Veins ................................................................................ 69 Other Biopsy Procedures ........................................................... 202 Central Veins—Superior and Inferior Vena Cava .................. 72 Aspiration Procedures ................................................................ 207 Renal and Adrenal Veins .............................................................. 75 Image Guided Drainage Procedures ...................................... 210 Extremity Veins .............................................................................. 78 Sclerotherapy of a Fluid Collection ......................................... 215 Portal and Hepatic Veins and TIPS ............................................ 80 Endovenous Ablation Therapy ................................................ 218 Arteriovenous Fistula and Interventions ................................. 85 Stab Phlebectomy ....................................................................... 221 Venous SamplingSample .......................................................................... 93 Venous Sclerotherapy ................................................................ 224 Chapter 4: Vascular Interventions ................................ 95 Sacroplasty ................................................................................... 226 Percutaneous Embolization—Other than Cerebral, Head and Neck ................................................................... 95 Vertebroplasty ............................................................................. 228 Transcatheter Thrombolysis Other Than Intracranial .......... 99 Kyphoplasty .................................................................................. 231 Percutaneous Thrombectomy ................................................. 102 Myelography ................................................................................ 234 Percutaneous Vascular Filter Placement, Repositioning, Chapter 8: Gastrointestinal Tract Interventions .......... 237 and Removal ..................................................................... 105 Percutaneous Cholecystostomy .............................................. 237 Percutaneous Transcatheter Retrieval of Foreign Body ....110 Percutaneous Cholangiography ............................................. 240 Intravascular Ultrasound, Non-coronary ............................... 113 Biliary/Drainage Catheter Placement .................................... 243 Transcatheter Biopsy .................................................................. 115 Conversion/Exchange and Removal of Biliary Transcatheter Endovascular Revascularization— Stent/Drainage Catheter .............................................. 247 Overview ............................................................................ 117 Biliary Stent Placement/Drainage ........................................... 251 Transcatheter Endovascular Revascularization— Other Biliary Procedures ............................................................ 255 Iliac Vascular Territory .................................................... 119 Esophageal Dilation ................................................................... 259 © 2018 Optum360, LLC i © 2017 American Medical Association. All Rights Reserved. Complete Guide for Interventional Radiology Chapter 4: Vascular Interventions Percutaneous Vascular Filter Placement, Repositioning, and Removal Vascular filters are placed in the inferior vena cava (IVC) in patients at risk of pulmonary embolism from known deep vein thrombosis. In the interventional radiology area, these filters are placed via percutaneous transcatheter approach. Special catheters containing a pre-loaded filter are inserted into the IVC via femoral vein or internal jugular approach and the filter is deployed. The filter grips the walls of the vena cava and is designed to “catch” clots migrating from the lower extremities. Filters may be temporary or permanent. 37191 Insertion of intravascular vena cava filter, endovascular approach including vascular access, vessel selection, and radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance (ultrasound and fluoroscopy), when performed 37192 Repositioning of intravascular vena cava filter, endovascular approach including vascular access, vessel selection, and radiological supervision and interpretation, intraprocedural
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