Diagnosis Code for CCSVI

A forum to discuss Chronic Cerebrospinal Venous Insufficiency and its relationship to Multiple Sclerosis.

Diagnosis Code for CCSVI

Postby IHateMS » Sat Aug 21, 2010 1:55 pm

What is the Dx code/s for CCSVI?
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Postby Cece » Sat Aug 21, 2010 3:04 pm

This is one that has been used, I'm not sure if it's the right one. If someone comes up with a better one, I'll update my notes.
Venous insufficiency unspecified (459.81) is a billable indication for a venous exam (sure I use this mostly for varicose vein studies). Head and neck swelling would definitely be a legitimate reason to scan these folks.

CPT CODES

36011 Procedure
70549 MRV/MRI
70546
93970 Ultrasound

I also don't know who I'm quoting there, but it was somone on this site some time ago.
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Postby walcat » Sun Aug 22, 2010 6:46 pm

This came from Joan's Facebook dated 21 Aug 2010.
venogram-75820, 75860, 75870, 75872, 75945, 37250
Venous Ultrasound-93970
Angioplasty/Stenting-35475, 75962, 37205,75960
Diagnosis Code-459.81
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Postby Cece » Sun Aug 22, 2010 11:20 pm

also from facebook page in response to the above list:
Henry Jacobs: Question whether many of these codes will indeed work. Perhaps for isolated instances where Medicare or health insurance is not checking up, but they were not really intended for CCSVI diagnosis or treatment.

For example diagnosis code 45981 has traditionally been used for venous peripheral insufficiency such as leg or arm, not central venous insufficiency (which is what is referred to in CCSVI).

Also, venous ultrasound code 93970 is for a scan of extremity veins, not internal jugular or vertebral which again are central veins and not extremity veins.

Several of the other codes are also mismatched – some referring to arteries, extremities, or other areas or other procedures.


it is a start at least!
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Postby CureIous » Mon Aug 23, 2010 12:24 am

Straight off my Explanation of Benefits, which my BC/BS insurance paid out for the procedure last year. This is straight off my bill, not some website.

Total bill was 112k. Insurance adjustments=78k. Check paid=38,000 out the door. That was for 4 stents though plus overnight bed.
I'm still not sure if they get to write off the 78k. Be interesting to find out.

Radiologist bill:
70549 MR Angiograph Neck W/Dye
70553 MRI with/without

Surgeon's bill:
36011 Place catheter in vein x 1
36012 Place catheter in vein x 2
37205 Percut. transcath IV stent (procedure for the stent not the stent)
37206 Percut. transcath IV stent additional.
75774 Artery X-ray each vessel
75860 Vein X-ray Neck x 2
75960 Transcath IV stent RS&I x2 (not sure what the rsi means).

These specifically were the surgeons fees paid to the doctor, not the op room or anything else like stents/caths etc. My insurance paid them without so much as a whimper, delightfully surprising me, but I guess that's why they are call contracted hospitals after all....

Mark.
RRMS Dx'd 2007, first episode 2004. Bilateral stent placement, 3 on left, 1 stent on right, at Stanford August 2009. Watch my operation video: http://www.youtube.com/watch?v=cwc6QlLVtko, Virtually symptom free since, no relap
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Postby frodo » Mon Aug 23, 2010 12:43 am

Henry Jacobs: Question whether many of these codes will indeed work. Perhaps for isolated instances where Medicare or health insurance is not checking up, but they were not really intended for CCSVI diagnosis or treatment.

For example diagnosis code 45981 has traditionally been used for venous peripheral insufficiency such as leg or arm, not central venous insufficiency (which is what is referred to in CCSVI).

Also, venous ultrasound code 93970 is for a scan of extremity veins, not internal jugular or vertebral which again are central veins and not extremity veins.

Several of the other codes are also mismatched – some referring to arteries, extremities, or other areas or other procedures.


Just one question. When we speak about the nervous system, the central system are the brain and the spine, but when we speak about the vascular system, does it really exist a "vascular central system"? shouldn't this expression refer to the heart instead of the brain? Brain is not central from the vascular point of view.
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Postby Henry_Jacobs » Mon Aug 23, 2010 8:19 pm

frodo wrote:
Henry Jacobs: Question whether many of these codes will indeed work. Perhaps for isolated instances where Medicare or health insurance is not checking up, but they were not really intended for CCSVI diagnosis or treatment.

For example diagnosis code 459.81 has traditionally been used for venous peripheral insufficiency such as leg or arm, not central venous insufficiency (which is what is referred to in CCSVI).

Also, venous ultrasound code 93970 is for a scan of extremity veins, not internal jugular or vertebral which again are central veins and not extremity veins.

Several of the other codes are also mismatched – some referring to arteries, extremities, or other areas or other procedures.


Just one question. When we speak about the nervous system, the central system are the brain and the spine, but when we speak about the vascular system, does it really exist a "vascular central system"? shouldn't this expression refer to the heart instead of the brain? Brain is not central from the vascular point of view.


Someone alerted me that I was quoted here so let me clarify one thing:
Central veins are those that go directly to the heart verses peripheral veins located in the extremeties. The internal jugular vein is considered a central vein. I mentioned this relating to the use of the diagnosis code 459.81 which I believe is for peripheral venous insufficiency and not central (such as IJV).
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