CPC Chapter Review - Cardiovascular- Medical Coding Course Review and Practice Questions

Summary

This video provides a comprehensive guide to medical coding, focusing on cardiovascular and renal procedures. The speaker demonstrates how to accurately select CPT and ICD-10 codes for procedures like renal angiography, femoral-femoral bypass grafts, and arteriovenous fistula revisions. Key concepts such as modifiers for professional components, the use of gore-tex in grafts, and the distinction between stable and unstable angina are discussed. The video aims to help viewers understand the coding process and ensure they can navigate complex cases with confidence.

Takeaways

• 😀 The process of selecting the correct CPT codes involves analyzing the procedure and identifying specific terms like 'bilateral', 'arterial', and 'gore-tex' to ensure accuracy.
• 😀 When performing angiographies, the professional component is crucial. This means selecting codes that reflect the interpretation and not the technical component.
• 😀 For bypass grafts, understanding the material used (e.g., Gore-Tex vs. vein) helps to choose the correct CPT code, ensuring the right match for artificial versus native vein grafts.
• 😀 In a case of renal artery angiography, it's important to select a bilateral code when both sides are involved, ensuring accurate documentation of the procedure.
• 😀 For femoral bypass grafts, codes vary depending on the material used for the graft, with Gore-Tex requiring a different code than those involving veins.
• 😀 When revising a fistula, it's critical to differentiate between revision and creation. The correct CPT code for revision (36832) should be selected for open procedures.
• 😀 In end-stage renal disease cases requiring dialysis access, selecting the right code for fistula revision is vital. Look for terms like 'revision' and 'autogenous' for proper coding.
• 😀 Angina pectoris requires careful code selection, especially distinguishing between unspecified and unstable types when documenting the diagnosis (e.g., I20.9 vs. I20.0).
• 😀 Radiological supervision and interpretation are billed separately under professional components, often requiring a 26 modifier to indicate that only interpretation (not equipment usage) was provided.
• 😀 CPT codes for angiographies, such as 75716 for bilateral extremity angiographies, may require modifiers like 26 for the professional component when only the interpretation is involved.

Q & A

What is the first step in identifying the correct CPT code for renal artery angiography?

The first step is to look up the procedure in the index, specifically under 'angiography,' then locate 'renal artery' to find the corresponding CPT code range. This helps identify whether the procedure was unilateral or bilateral.

Why is the code for unilateral renal artery angiography different from bilateral?

The code for bilateral renal artery angiography is different because it involves both the right and left renal arteries, whereas a unilateral angiography involves only one side. For bilateral procedures, a specific code, such as 36252, is used.

What is the significance of Gore-Tex in the femoral femoral bypass grafting procedure?

Gore-Tex is significant because it is an artificial material used for bypass grafting, distinct from using a native vein. The code selection depends on whether the graft uses a vein or a synthetic material like Gore-Tex.

What CPT code is used for femoral-femoral bypass grafting with Gore-Tex?

The correct CPT code for a femoral-femoral bypass grafting using Gore-Tex (other than vein) is 35661.

What is the key difference between the codes 36831, 36832, and 36825 in relation to dialysis fistula revision?

The key difference lies in the type of procedure: 36831 is for the creation of an arteriovenous fistula, 36832 is for the revision of an autogenous fistula, and 36825 is for graft procedures. Since the scenario involves a revision, the correct code is 36832.

What does the 26 modifier signify in CPT coding?

The 26 modifier signifies the professional component of a procedure, meaning it refers to the interpretation and analysis portion of the service, not the use of equipment or technical components.

In the case of bilateral angiography of the legs, which modifier is appropriate if only the professional component is provided?

For bilateral angiography of the legs with radiological supervision and interpretation, the appropriate modifier is 26, as it indicates that only the professional component of the procedure is being billed.

How do ICD-10 codes differ in relation to the diagnosis of angina pectoris in the context of angiography?

ICD-10 codes for angina pectoris can either be unspecified (I20.9) or unstable (I20.0). The scenario in the transcript mentions unspecified angina, which corresponds to I20.9.

Why is the code 75716 used for bilateral extremity angiography?

Code 75716 is used for bilateral extremity angiography because it specifically refers to angiographic procedures involving both legs, which is what the patient underwent in the example provided.

Why is modifier 26 necessary when billing for radiological supervision and interpretation only?

Modifier 26 is necessary when billing for radiological supervision and interpretation because it indicates that the provider is billing for the professional component (the interpretation) of the procedure, not the technical component (use of equipment).