More accurate IR coding starts with a better understanding of how IR procedures are performed
We built Essentials of Interventional Radiology Coding on a simple, but profound, premise: that better IR coding starts with a strengthened understanding of how IR procedures are performed and how to pinpoint those key phrases in physician documentation.
There’s nothing simple about IR coding, of course. For example, the emergence of bundled codes was supposed to make life easier for coders. But, in fact, it presented new challenges in terms of interpreting physician documentation and then arriving at the correct bundled code. Speaking of documentation, it seems that no two physicians document an IR procedure the same way, magnifying the gray areas that make it hard to distinguish subtle differences between procedures and similar code choices.
Fully updated, this popular resource provides in-depth explanations of the “why” behind correct CPT®/HCPCS code assignments, as well as valuable guidance with interpreting physician documentation in all its variations. You don’t have to be a new coder to benefit from this book, it’s a great resource for experienced coders and even non-clinical staff who want to expand their understanding of IR coding.
Features and Benefits
Clearly and concisely, our IR coding experts cover many essential concepts, such as:
- Descriptions of IR procedures, including both diagnostic exams and therapeutic interventions, as well as vascular angiography and interventions, and how each one is performed — including subtle differences that make a big difference in how procedures are reported
- Corresponding CPT/HCPCS code descriptions and coding guidelines for each procedure; covers code assignments by both hospital (technical) and physician (professional) entities
- Explanations of any applicable add-on, radiological S&I and imaging guidance codes, with guidelines for use
- Critical elements in physician documentation that lead to correct code assignments
- Guidance with IR coding concepts, including component, hybrid, bundled, arterial, venous, selective, non-selective and order of selectivity
- Overviews of other must-know topics: diagnostic vs. therapeutic procedures, physician vs. hospital coding, Medicare payments and coding guidelines, CPT coding basics and much more
Updated to address coding changes and new challenges:
- Step by step through new, deleted and revised codes for reporting IR procedures
- Guidance through any revisions to IR coding guidelines
- Updated billing tips and expanded guidance through common problem areas
- New case examples
A proven approach to effective learning and quick reference for busy professionals:
- Content is organized by nonvascular and vascular IR, and then by body system and procedure type
- Anatomical illustrations showing, and visually translating, common procedures and the corresponding CPT codes
- At the end of each chapter, full dictated reports with highlighted key phrases that lead to the correct code assignments
Looking for more valuable coding education and news? Check out our new Interventional Radiology All-Access Pass and/or our Comprehensive Radiology All-Access Pass.
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Introduction
Abbreviations
Modifiers
A Note About COVID-19
- Additional Supplies During the Public Health Emergency
The Basics
- Diagnostic vs. Therapeutic
- Global, Technical, and Professional
- Hospital vs. Physician Coding
- Physician / Other Qualified Healthcare Provider
- Guidance
- Moderate (Conscious) Sedation
- Coverage
- Evaluation and Management for Interventional Radiology
- Global Surgical Period
- 3D Printing
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
Pleural Aspiration / Drainage
Abdominal Aspiration / Drainage
- Paracentesis
- 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 — Electroporation
Ablation Guidance Codes
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
- 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
Vertebroplasty, Vertebral Augmentation, and Sacroplasty
Lumbar Spine Allogeneic Injection
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
- Case 3: Joint Injection and Aspiration
Digestive System, Biliary System and General Abdominal Procedures
Salivary Glands
Esophagus
Stomach
Colon and Rectum
Liver
Biliary Tract
Pancreas
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
- Case 2: Cholangiogram with Stone Removal
- Case 3: Tunneled Peritoneal Catheter
Urinary System
Diagnostic Studies
Therapeutic Procedures
Sample Cases: Urinary System
- Case 1: Loopogram
- Case 2: Exchange of Nephroureteral Stent
- Case 3: Brush Biopsy and Ureteral Stent Placement
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
- 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
- Arch, Carotid, and Vertebral 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
Mechanical Thrombectomy
Embolization
Lower Extremity Revascularization
- Intravascular Lithotripsy
- Endovenous Femoral-Popliteal Arterial Revascularization
- Endovascular Venous Arterialization
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
Sample Cases: Vascular Interventions
- Case 1: Carotid Arteriogram and Intervention
- Case 2: Carotid Embolization
Thoracic, Abdominal, and Iliac Stent Grafts
- EVAR—Abdominal Aortic Aneurysm (AAA) Stent-Grafts (Non-fenestrated)
- FEVAR—Fenestrated Endovascular Repair of the Visceral and Infrarenal Aorta
- TEVAR—Thoracic Endovascular Aneursym Repair
Sample Case: Endovascular Stent Graft
Arteriovenous Dialysis Graft Angiography and Intervention
- Percutaneous Creation of Arterivenous Fistula
Sample Case: Arteriovenous Grafts
Miscellaneous Vascular Interventions
- Vena Cava Filter
- Intravascular Foreign Body Removal
- Transcatheter Biopsy
- Transvenous Intrahepatic Portosystemic Shunts (TIPS)
- Thrombin Injection
- Transcatheter Ultrasound Ablation of Pulmonary Artery Nerves
- Y-90 Radioembolization
- Intravascular Ultrasound (IVUS)
Sample Cases: Miscellaneous
- Case 1: Transjugular Biopsy
- Case 2: IVC Filter Placement
