even if you perform an entire AAA assessment and renal artery assessment, and charge for both, medicare will not reimburse for both performed on the same day ( even if the pt. is positive for both AAA and RAS) ... this is what my billers have told me anyway...

On Tue, Feb 8, 2011 at 10:11 AM, Denise Levy <[log in to unmask]> wrote:

Joel, Renals and mesenteric should not cause a change on laminar flow in the aorta unless diseased... However a pet peeve of mine,, Aorta iliac should include 3 vel of the aorta, 2 of each iliac prox and mid, and both CFA velocities... The iliacs are lengthy and full of disease from the umb bifurcation to the groin... Patients for a lower extremity arterial and they had an aorta the day before at another facility that is negitive,,,and they present with low velocity monophasic waveforms the aorta scan is useless if just done for AAA. Iliac aneurysms can occur distal to the orgins and stenosis.    This is my concern that we study aorta iliac not just the AAA but for PAD as well. I know the IR MDs would love for you to find more disease. What are your thoughts.

Denise Levy
408 391 0837
RVT, RDMS
TCD
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On Feb 8, 2011 9:43 AM, "Joel D" <[log in to unmask]> wrote:
>
> I work for a vascular interventionalists. For our aorto iliac duplex we bill 93978 focusing mainly on aneurysm assessment and velocity measures through the aorta and both commons. I always look at all the proximal branches of the aorta with color per our protocol. Occasionally this will lead me to sampling with Doppler in one of these branches. Say I see turbulence with color and sample the Renal artery. My Dr. says I should then also be circling limited renal for instance if I'm doing this. I've always just assumed this is part of the exam and have not been calling it anything but that as far as billing. We have a separate billing department who process the routers which we fill out. Please enlighten me since I see many of you do your own billing. Thanks!
>
> Joel
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