Billing for Vascular Procedures
Billing for vascular procedures should have supporting physician documentation and medical records.
Procedures can be diagnostic or therapeutic -- diagnostic vascular procedures help to diagnose tumors, thrombosis, plaque formation, aneurysms, hemorrhage and malformations in the arteries and veins.
Therapeutic vascular procedures include intraluminal stent placement, balloon angioplasty, embolization, vena cava filter placement and thrombolytic therapy.
Procedures performed in outpatient hospital departments, ambulatory surgery centers or vascular access centers can be billed.
The reimbursement would depend upon the services provided and the place of service.
Payers require physicians to report CPT codes for radiological supervision and interpretation with the CPT codes for interventional procedures.
It is to be noted that radiological services performed in conjunction with interventional procedures are not reimbursed separately by Medicare.
You should also take care to use the modifier -26 with various radiological supervision and interpretation CPT codes, except when the radiological equipment is owned by the physician performing these services.
The service provider is responsible for providing the accurate diagnostic and procedural codes.
Hospital inpatient procedure codes include the ICD-9 codes for peripheral procedures, and the adjunct codes for inpatient vascular procedures.
The outpatient codes (physician codes or CPT codes) include those for catheter placement, peripheral angiography with radiological supervision and interpretation, Peripheral Procedural Radiological Supervision and Interpretation, Peripheral Angioplasty, Peripheral Stent Placement, and Arteriovenous Graft/Shunt Procedures.
The code for vessel closure is G0269.
This code is used to report the placement of an occlusive device in a venous or arterial access site, interventional or post-surgical procedure.
In Medicare claims, G0269 has to be used to report the placement of the vasoseal.
Some Points to Remember • Vascular codes have to be assigned according to the types of catheters, tunneling techniques and patient's age.
Billers have to be familiar with the CPT codes to report repair and removal of central venous access catheters.
A detailed study of the CPT code manual is necessary to understand the correct codes.
There are replacement codes which can be used only if the catheter is being replaced through the same venous access site.
The removal of a tunneled catheter can be reported, whereas a non-tunneled catheter removal is not separately reported since it is included in the insertion charge.
• When radiologic imaging is used to guide catheter insertion, the code 75998 is used to report fluoroscopy and 76937 for ultrasound.
• Invasive procedures involve a procedural or surgical component as well as a radiologic supervision and interpretation (S&I) component; both of these have to be separately coded.
All vessels imaged, even those not catheterized, have to be reported.
Separate codes are to be assigned to vessels treated separately, and individual interventional services can be coded separately.
When it comes to coding imaging and S&I, the imaging has to be reported separately from the intervention, the imaging codes whether technical or S&I, should include all necessary views.
A single access for multiple services can be reported only once.
How a Medical Billing Company Can Help Trained and experienced medical billers in reputable companies are well-versed in the CPT codes and their descriptions for interventional procedures, inpatient hospital billing codes, revenue codes, HCPCS codes, and C-codes under the Outpatient Prospective Payment System (OPPS) to track device cost information.
They are also knowledgeable regarding the codes to assign for non-invasive vascular diagnostic studies (NVDS).
They are thorough with aspects such as billing frequency limitations, and the modifiers required.
One of the things that makes vascular medical billing complex is the individual requirements of different insurance payers.
This is something only a professional medical biller would know.
A reliable medical billing company with its capable staff will be able to assist physicians and patients in aspects such as eligibility, covered services, reimbursement on the basis of place and date of service and more.
With the support of a dedicated medical billing company, service providers can obtain maximum reimbursement, avoid claim denials and improve their practices.
Procedures can be diagnostic or therapeutic -- diagnostic vascular procedures help to diagnose tumors, thrombosis, plaque formation, aneurysms, hemorrhage and malformations in the arteries and veins.
Therapeutic vascular procedures include intraluminal stent placement, balloon angioplasty, embolization, vena cava filter placement and thrombolytic therapy.
Procedures performed in outpatient hospital departments, ambulatory surgery centers or vascular access centers can be billed.
The reimbursement would depend upon the services provided and the place of service.
Payers require physicians to report CPT codes for radiological supervision and interpretation with the CPT codes for interventional procedures.
It is to be noted that radiological services performed in conjunction with interventional procedures are not reimbursed separately by Medicare.
You should also take care to use the modifier -26 with various radiological supervision and interpretation CPT codes, except when the radiological equipment is owned by the physician performing these services.
The service provider is responsible for providing the accurate diagnostic and procedural codes.
Hospital inpatient procedure codes include the ICD-9 codes for peripheral procedures, and the adjunct codes for inpatient vascular procedures.
The outpatient codes (physician codes or CPT codes) include those for catheter placement, peripheral angiography with radiological supervision and interpretation, Peripheral Procedural Radiological Supervision and Interpretation, Peripheral Angioplasty, Peripheral Stent Placement, and Arteriovenous Graft/Shunt Procedures.
The code for vessel closure is G0269.
This code is used to report the placement of an occlusive device in a venous or arterial access site, interventional or post-surgical procedure.
In Medicare claims, G0269 has to be used to report the placement of the vasoseal.
Some Points to Remember • Vascular codes have to be assigned according to the types of catheters, tunneling techniques and patient's age.
Billers have to be familiar with the CPT codes to report repair and removal of central venous access catheters.
A detailed study of the CPT code manual is necessary to understand the correct codes.
There are replacement codes which can be used only if the catheter is being replaced through the same venous access site.
The removal of a tunneled catheter can be reported, whereas a non-tunneled catheter removal is not separately reported since it is included in the insertion charge.
• When radiologic imaging is used to guide catheter insertion, the code 75998 is used to report fluoroscopy and 76937 for ultrasound.
• Invasive procedures involve a procedural or surgical component as well as a radiologic supervision and interpretation (S&I) component; both of these have to be separately coded.
All vessels imaged, even those not catheterized, have to be reported.
Separate codes are to be assigned to vessels treated separately, and individual interventional services can be coded separately.
When it comes to coding imaging and S&I, the imaging has to be reported separately from the intervention, the imaging codes whether technical or S&I, should include all necessary views.
A single access for multiple services can be reported only once.
How a Medical Billing Company Can Help Trained and experienced medical billers in reputable companies are well-versed in the CPT codes and their descriptions for interventional procedures, inpatient hospital billing codes, revenue codes, HCPCS codes, and C-codes under the Outpatient Prospective Payment System (OPPS) to track device cost information.
They are also knowledgeable regarding the codes to assign for non-invasive vascular diagnostic studies (NVDS).
They are thorough with aspects such as billing frequency limitations, and the modifiers required.
One of the things that makes vascular medical billing complex is the individual requirements of different insurance payers.
This is something only a professional medical biller would know.
A reliable medical billing company with its capable staff will be able to assist physicians and patients in aspects such as eligibility, covered services, reimbursement on the basis of place and date of service and more.
With the support of a dedicated medical billing company, service providers can obtain maximum reimbursement, avoid claim denials and improve their practices.
Source...