AHA Coding Clinic® for HCPCS - 2011 Issue 3; ASK the EDITOR

Closure device placement

Under the cardiac catheterization section in the CPT codebook there is a sentence in regards to closure device placement. The sentence states: “Closure device placement at the vascular access site is inherent to the catheterization procedure and not separately reportable.” A similar sentence in the CPT codebook, under the endovascular revascularization (open or percutaneous transcatheter) section, sentence states: “These lower extremity endovascular revascularization codes all include the work of accessing and selectively catheterizing the vessel…. directly related to the intervention(s) performed… closure of the arteriotomy by any method, …” From my understanding of these instructions, a code from the CPT section of the manual would not be used to identify that a closure device was utilized. This is supported by the National Correct Initiative (NCCI) Manual version 16.3 chapter XI (page XI-15 #18) which states: “Placement of an occlusive device such as an angioseal or vascular plug into an arterial or venous access site after cardiac catheterization or other diagnostic or interventional procedure should be reported with HCPCS code G0269. A physician should not separately report an associated imaging code such as CPT code 75710 or HCPCS code G0278.” Coding resources are stating that HCPCS code G0269 can no longer be reported with the cardiac catheterization or endovascular code sections. Are they misunderstanding the intent of the instructional note? CMS created code G0269 in January 2003 to ensure that hospitals report the procedure correctly. Although the procedure code carries a packaged status, CMS has made it clear that hospitals should report packaged codes when the service has been provided. Your clarification of this matter is greatly appreciated. ...

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