I was just notified by my billing company that one of our major private carriers (UHC) is bundling the 36902 code with 36581 for all their patients. Thus they are denying the 36902. Has anyone else run into this problem and how did you resolve it. I have scheduled a physician to physician conference call with the medical director to express my disagreement with there ruling. I would love to hear anyone else’s similar experience.

Best Regards R Kris Ellis MD FASN, FASDIN

I am looking for some guidance on a coding issue.  This doesn't seem to be specifically addressed in the coding manual.    This particular case began with a pateint with falling access flows a fistulagram was ordered and revealed an outflow occlusion in the primary outflow brachial vein.  The access was kept open via a communicator to the brachial vein.  

I was able to get across the the occlusion ultimately, and we were able to re-cannulate the access.  

This case required multiple wires adn guiding catheters to cross the occlusion and multiple balloons, and finally a stent and anticoagulation the re-cannulte the access.  Clearly there are more resources, time and risk involved than fistulagram.

Does anyone have experience with the most appropriate codes to use? Is this best coded as a thrombectomy, thrombectomy-in-situ, or just a PTA?

Thank you,

Craig Kleinmann