Understanding the intricacies of coding for non-coronary stents can be daunting, but it’s crucial for ensuring accurate billing and reimbursement. This guide will walk you through an example to simplify the process and help you get started.
Coding Components for Non-Coronary Stents
When coding for procedures performed in non-coronary vessels, it’s essential to code all the components plus the radiological supervision separately. Here’s an example of coding for a right renal artery procedure, including catheter placement, arteriography, percutaneous transluminal coronary angioplasty (PTCA), and a stent placement.
Example: Right Renal Artery Procedure
Catheter Placement:
• Assuming the procedure begins at the aorta and proceeds to the right renal artery, this would be considered a first-order catheterization.
• Code: 36245
• Description: Selective catheter placement in the arterial system, first-order abdominal, pelvic, or lower extremity branch within a vascular family.
Stent Placement:
• Code: 37205
• Description: Transcatheter placement of intravascular stent(s), percutaneous, including radiological supervision and interpretation.
Percutaneous Transluminal Coronary Angioplasty (PTCA):
• Code: 35471
• Description: Transluminal balloon angioplasty, percutaneous; each additional branch of a non-coronary vessel.
Radiological Supervision and Interpretation:
• Code: 75960
• Description: Transcatheter introduction of intravascular stent(s), radiological supervision and interpretation. Consider using modifier 26 for professional component.
This example highlights the need for component coding and the importance of coding each part of the procedure separately.
Additional Tips for DME/HME Companies
• Stay Informed: Keep updated with the latest coding guidelines and changes from authoritative sources like CMS.gov.
• Use Reliable Resources: A thorough Google search for “non-coronary stent coding” can yield valuable resources, such as PDFs from CMS, to aid in understanding and applying correct codes.
• Continuing Education: Regularly attend webinars and training sessions to stay current with best practices in medical coding and billing.
Conclusion
Accurate coding for non-coronary stents is vital for ensuring proper reimbursement and avoiding denials. By understanding the individual components and using the correct codes, DME/HME companies can improve their billing processes and overall efficiency.
For more tips on DME billing and coding, visit DME Billing Pro.