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| Coding Change for Percutaneous Transluminal Balloon Angioplasty The Centers for Medicare and Medicaid Services (CMS) has decided that only one percutaneous transluminal balloon angioplasty code can be reported when intervening on a hemodialysis graft. The graft is considered a single vessel and is defined as: the arterial anatomosis and the ouflow vein up to, but not including, the subclavian vein. The two codes are G0392 (transluminal balloon angioplasty, percutaneous; for maintenance of hemodialysis access; AV fistula or graft; arterial) and G0393 (same but venous). SVS submitted comments to CMS advising the agency to define the anatomic limits of the two G-codes. The code with higher RVU value (G0392) will be used if both codes of the code pair are reported together. View the National Correct Coding Initiative letter with additional details. |
| New NCCI Edits Effective April 1, 2008 The NCCI physician edits have been announced as being effective in the editor programs of the Carriers claims processing files, effective April 1, 2008. Click here to download the NCCI physician edits |
| Medicare Agrees with SVS – No Changes for Renal PTA Since at least 1994, renal percutaneous transluminal angioplasty (PTA) has been nationally covered by Medicare to treat atherosclerotic obstructive lesions. The language contained in the Centers for Medicare and Medicaid Services (CMS) Coverage Manual is as follows: “Of the renal arteries for patients in whom there is an inadequate response to a thorough medical management of symptoms and for whom surgery is the likely alternative. The PTA for this group of patients is an alternative to surgery, not simply an addition to medical management.”1 However in February 2007, the CMS Coverage and Analysis Group initiated a process to re-examine which patient populations and which circumstances the Medicare program should cover renal stenting. The SVS provided CMS with two sets of comments and numerous literature citations regarding renal PTA, including that it was reasonable and necessary for patients who do not respond well to medical management. SVS leadership also presented testimony at the Medical Evidence Development Coverage Advisory Group (MedCAC) Panel meeting in July 2007 regarding the need to maintain the current coverage and to not require evidence development or enrollment in a clinical trial as a pre-requisite for Medicare coverage. SVS is pleased to share with its members that on February 14, 2008, CMS decided to make no change in current national coverage for renal PTA. To access all the comments, CMS decision memos, and coverage manual language on this subject, please click on the following link: http://www.cms.hhs.gov/mcd/viewtrackingsheet.asp?id=202 |
| NCCI Appeal Letter SVS joined by the American College of Cardiology, American College of Radiology, Society for Cardiovascular Angiography and Intervention and the Society of Interventional Radiology submitted a letter to the National Correct Coding Initiative opposing the recent revision of its Policy Manual for Medicare Services. The revision asserts that only the "final" procedure is reportable for percutaneous minimally invasive therapeutic interventions, contradicting coding conventions for these services. |
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© 2009 VascularWeb. All rights reserved. Use of the VascularWeb site constitutes acceptance of all of the policies, rules and regulations for the site.