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What is the proper CPT Code to use?
A patient was seen on our office on 7/29 who had 2 weeks prior a surgery to drain an abdominal wall access. The reason for his visit on 7/29 was for uncontrollable bleeding that wouldn't stop during a wound-vac change. Per the physician's notes:
Bleeding vessel near skin in inferior abdominal wall is identified and tied off with
2-0 vicryl suture. No further bleeding. The physician is telling me to use a 37617-
ligation of abdomen artery. Is this the correct code to use for an in-office procedure. Please reply, thank you.
strange one
This is the lay description:
The physician performs an abdominal incision to best expose the involved artery. The physician identifies the injured artery and quickly clamps it to reduce blood loss. The physician ties off the artery completely (ligation), proximal and distal to the site of injury. The physician closes the abdomen, leaving drains in place.
It seems correct but not in office??
What is the proper CPT code to use
Make sure the Physician understands that CPT definition of 37617 is Ligation, Major Artery. From the description you gave I cannot determine this to be a major artery ligation. (renal, aorta, celiac and branches IVC or other major branch off aorta)
If there is not a CPT code that accurately describes the service CPT says to report the unlisted procedure code in the correct category of codes. I personally would use an unlisted procedure code, send the documentation and explain your charge ( a comparable CPT code RVU) 37799.
Global period?
You also have to consider the fact that you are likely in a global period. If this payer follows Medicare, you cannot bill separately for complications unless it requires a return to the OR.
So, you'll also be looking at the appropriate modifier to use. 78 is return to the OR or procedure room, but not for Medicare. Medicare stills requires it to be an OR.