Basics of Interventional Radiology Coding 2017

Transcription

1 Basics of Interventional Radiology Coding 2017 Prepared and Published By: MedLearn Publishing A Division of Panacea Healthcare Solutions, Inc. 287 East Sixth Street, Suite 400 St. Paul, MN

2 TABLE OF CONTENTS Introduction... 1 Abbreviations... 2 Modifiers... 5 The Basics Diagnostic vs. Therapeutic Global, Technical, and Professional Hospital vs. Physician Coding Physician / Other Qualified Healthcare Provider Guidance Moderate (Conscious) Sedation Coverage Part 1: NON-VASCULAR INTERVENTIONAL RADIOLOGY Biopsy Guidance Aspiration Biopsy Non-Aspiration Needle Biopsy Breast Biopsy Breast Localization Without Biopsy Post-Procedure Mammogram Specimen Radiograph Soft Tissue Marker Sample Cases: Biopsy Case 1: Ultrasound-Guided Fine Needle Aspiration Right Neck Lymph Node Case 2: Ultrasound Breast Biopsy Left Drainage Cyst Aspiration Joint Aspiration Catheter-Assisted Drainage...35 Pleural Aspiration / Drainage Abdominal Aspiration / Drainage Paracentesis iii

3 Tunneled Intraperitoneal Catheter Cholecystostomy Tube Placement Drainage Catheter Check and Change Sclerosis Other Aspiration / Drainage Sample Cases: Drainage Case 1: Fluoroscopic and Ultrasound-Guided Placement of a Suprapubic Catheter (14-French Pigtail) Case 2: Thoracentesis Case 3: CT-Guided Pelvic Abscess Drainage Case 4: Ultrasound-Guided Right Thoracentesis, Ultrasound and Fluoroscopic-Guided Right Perinephric Drain Placement Ablation / Destruction Tumor Ablation Ablation Guidance Codes...47 Nerve Destruction Cyst Ablation Sample Cases: Ablation Case 1: Pulmonary RFA Case 2: Renal Cyst Aspiration and Sclerosis Pain Management Injections Spinal Injections Epidural Injections Facet Joint Injections Thoracic Paravertebral Block Sacroiliac Joint Injection...58 Blood Patch Other Pain Management Injections Sample Cases: Pain Management Case 1: Ultrasound-Guided Injection of the Posterior Knee Case 2: Synovial Cyst Aspiration and Facet Injection Spinal Procedures Lumbar Puncture Myelography Discography iv

4 Vertebroplasty, Vertebral Augmentation, and Sacroplasty Sample Cases: Spinal Procedures Case 1: Diagnostic Lumbar Puncture and Intrathecal Methotrexate Injection Case 2: Vertebroplasty Joint Procedures Arthrography Shoulder Elbow Wrist Hip Knee Ankle Sacroiliac Joint CT/MR Arthrography Aspiration, Arthrocentesis, Injection Sample Cases: Joint Procedures Case 1: Shoulder MRI Arthrogram Case 2: Wrist Injection...77 Digestive System, Biliary System and General Abdominal Procedures Salivary Glands Esophagus Stomach Colon and Rectum Liver Biliary Tract Pancreas Biopsy General Abdomen / Peritoneum Drainage Biopsy Fiducial Markers Peritoneal Cavity Evaluation and Catheters Gastrostomy, Duodenostomy, Jejunostomy, Cecostomy and Other Colonic Tubes Sample Cases: Digestive System, Biliary System, and General Abdominal Procedures Case 1: Cholangiogram, Biopsy, and Biliary Drainage v

5 Case 2: Cholangiogram with Stone Removal Urinary System Diagnostic Studies Therapeutic Procedures Sample Cases: Urinary System Case 1: Loopogram Case 2: Exchange of Nephroureteral Stent Part 2: VASCULAR INTERVENTIONAL RADIOLOGY Vascular Interventional Radiology Venous Access Venipuncture Central Venous Access Placement Centrally Inserted Peripherally Inserted Repair Replacement Removal Guidance Other CVA Catheter/Device Procedures Miscellaneous Venous Catheterization Procedures Sample Cases: Venous Access Case 1: Temporary Dialysis Catheter Placement Case 2: Tunneled Catheter and PICC Line Case 3: Tunneled Dialysis Catheter (TDC) Removal Treatment of Lower Extremity Incompetent Veins Sample Case: Incompetent Veins Diagnostic Angiography Vascular Angiography Basics Component Codes Vascular Angiography Catheterization Venous Non-selective Codes vi

6 Venous Selective Codes Arterial Non-selective Codes Arterial Selective Codes Diagnostic Imaging Venous S&I Codes Arterial S&I Codes Pulmonary S&I Codes Guidance Sample Cases: Component Coding Case 1: Abdominal Aortogram with Bilateral Lower Extremities Case 2: Right Upper Extremity Angiogram Complete Diagnostic Angiography Renal Angiography Carotid and Vertebral Diagnostic Angiography Sample Cases: Complete Angiography Case 1: Carotid/Vertebral Angiogram Case 2: Bilateral and Accessory Renal Artery Angiograms Vascular Interventions Angioplasty Stent Placement Atherectomy Thrombolysis Example Example Mechanical Thrombectomy Embolization Lower Extremity Revascularization Sample Cases: Vascular Interventions Case 1: Right Subclavian Angiogram and Stent Case 2: Aortic and Bilateral Iliac Artery Stenting Case 3: Popliteal Artery Stent Case 4: Visceral Embolization Carotid / Vertebral Interventions Angioplasty and Stent Placement Intracranial Mechanical Thrombectomy / Thrombolysis Non-Thrombolytic Agent Administration Occlusion / Embolization vii

7 Sample Cases: Vascular Interventions Case 1: Carotid Arteriogram and Intervention Case 2: Carotid Embolization Thoracic, Abdominal, and Iliac Aneurysm Stent Grafts EVAR Abdominal Aortic Aneurysm (AAA) Stent-Grafts (Non-fenestrated) Closure Additional Related Procedures Conversion to Open Repair FEVAR Fenestrated Endovascular Repair of the Visceral and Infrarenal Aorta TEVAR Thoracic Endovascular Aneursym Repair Additional Procedures Iliac Artery Endograft Additional Procedures Sample Case: Endovascular Stent Graft Arteriovenous Dialysis Graft Angiography and Intervention Sample Case: Arteriovenous Grafts Miscellaneous Vascular Interventions Vena Cava Filter Intravascular Foreign Body Removal Transcatheter Biopsy Transvenous Intrahepatic Portosystemic Shunts (TIPS) Thrombin Injection Y-90 Radioembolization Intravascular Ultrasound (IVUS) Sample Cases: Miscellaneous Case 1: Transjugular Biopsy Case 2: IVC Filter Placement viii