Upper extremity interventional radiology coding is an important area to take to task when it comes to accurate coding. With the pandemic still taking its toll on the financial health of many facilities, coding correctly has never been more important with both reimbursement and compliance on the table. Several tips and advice will help safeguard coding when faced with upper extremity services.
First know that when performing interventional procedures in addition to diagnostic angiography, it may be appropriate to charge separately for each portion of the study. Reference the CPT Manual for guidelines associated with each code to determine when diagnostic angiography may be separately coded.
Several definitions are key to unlocking successful coding including dialysis circuit components like peripheral dialysis segment and central dialysis segment.
CPT defines the segments of the dialysis circuit as follows:
Peripheral dialysis segment: The peripheral dialysis segment is the portion of the dialysis circuit that begins at the arterial anastomosis and extends to the central dialysis segment. In the upper extremity, the peripheral dialysis segment extends through the axillary vein (or entire cephalic vein in the case of cephalic venous outflow). In the lower extremity, the peripheral dialysis segment extends through the common femoral vein. The peripheral dialysis segment includes the historic “peri-anastomotic region.”
Central dialysis segment: The central dialysis segment includes all draining veins central to the peripheral dialysis segment. In the upper extremity, the central dialysis segment includes the veins central to the axillary and cephalic veins, including the subclavian and innominate veins through the superior vena cava. In the lower extremity, the central dialysis segment includes the veins central to the common femoral vein, including the external iliac and common iliac veins through the inferior vena cava.
Note that the most current information pertaining to CCI instructions relative to this topic can be found in the most recent NCCI Policy Manual for Medicare Services at https://www.cms.gov/Medicare/Coding/NationalCorrectCodInitEd/index.
These are not all the necessary coding tips and rationale essential for correct upper extremity coding and compliance. As service volumes rebound, now more than ever it is imperative to make sure your CPT® coding is correct and compliant. Master more interventional radiology topics and break down the complexity with expert-infused insight. Our Upper Extremity Interventional Radiology Coding webcast is an essential training tool for both audio and visual learners.
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