6 Step Successful Coding for Endovascular AAA Repair

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6 Step Successful Coding for Endovascular AAA
Repair

• Presented by Lori Dafoe, CPC

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DONT PANIC!
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Resources

• CPT
• Chapter Notes
• CPT Assistant Articles
• Laminated, color coded vascular charts
• Medlearn/Panacea
• Medical Asset Management
• National Correct Coding Initiative (NCCI) Edits
• Vascular Web
• Excellent physician documentation!

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Step 1 Is this an endovascular repair, or an
open repair?

• If the documentation records an open surgery
  directly at the aneurysm site, see CPT
  35001-35152 to report.

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Example of Open Repair
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STEP 2 Was there open surgical exposure of an
artery?

• Femoral Artery 34812
• Femoral Artery (Bilateral) 34812-50
• Iliac Artery (Unilateral) 34820
• Iliac Artery (Bilateral) 34820-50

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Example of Open Femoral Artery Exposure CPT
34812
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Example of Open Iliac Artery Exposure CPT 34820
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STEP 3 What catheters were introduced into the
aorta or aortic branches?

• Aorta alone (no selective catheterization)
  36200
• Aorta Bilateral (Identifies accessing aorta via
  both legs) 36200-50
• Aorta 1St Order Vessel (eg, renal artery) via
  different access points (Both legs) 36200 and
  36245

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STEP 4 What type of device was used for the
repair?

• Tube 34800
• Modular Bifurcated 34802
• Unibody Bifurcated 34804
• (Note Only one of these codes should be
  reported.)

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Tube Prosthesis CPT 34800
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Unibody Bifurcated Prosthesis CPT 34804
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STEP 5 Were other separately reportable
services provided?

• Examples include
• SI for Repair CPT 75952
• Extension Cuffs CPT 34825 and 34826
• SI for extension cuffs CPT 75953
• Balloon angioplasty outside endograft
• 35473 or 35454
• 35471 or 35450
• Arterial Occlusion or Embolization 37204

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Extension Cuffs CPT 34825/34826
Aortic Extender
Iliac Extender
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Step 6 Was the endovascular repair converted
to an open procedure?

• Tube prosthesis CPT 34830
• Aorto-bi-iliac prosthesis CPT 34831
• Aorto-bifemoral prosthesis CPT 34832

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6 Step Review

• Step 1 Is this an endovascular repair, or an
  open repair?
• Step 2 Was there open surgical exposure of an
  artery?
• Step 3 What catheters were introduced into the
  aorta or aortic branches?
• Step 4 What type of device was used for the
  repair?
• Step 5 Were other separately reportable
  services provided?
• Step 6 Was the endovascular repair converted
  to an open procedure?

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LETS PRACTICE CODING!
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RESOURCESCPT Assistanthttp//www.ama-assn.org/
ama/pub/physician-resources/solutions-managing-you
r-practice/coding-billing-insurance/cpt.pageMedl
earn/Panaceahttp//shop.medlearn.comMedical
Asset Managementhttp//www.medicalassetsmanagemen
t.com/Illustrations/illustrations.htmlNCCI
Editshttp//www.cms.gov/Medicare/Coding/NationalC
orrectCodInitEd/index.html?redirect/NationalCorre
ctCodInitEd/NCCIEP/list.aspVascular
Webhttp//www.vascularweb.org/Pages/default.aspx