Catheter with Angioplasty Procedure

Question:

If a third-order catheter is pulled back and enters the iliac, which is then treated with angioplasty, can you code that selective iliac catheterization in addition to the angioplasty?

Answer:

​No, because catheterization is inclusive to lower extremity arterial revascularization interventions, such as an arterial angioplasty and stenting. Report the angioplasty only.

*This response is based on the best information available as of 10/23/25.

14000 and 19301 for Partial Mastectomy?

Question:

Should cpt code 14000 ADJACENT TISSUE TRANSFER OR REARRANGEMENT, TRUNK; DEFECT 10 SQ CM be billed with cpt code 19301 MASTECTOMY; PARTIAL? Insurances tend to disallow it stating it is included in 19301. This is how our surgeon describes 14000, a parenchymal flap advancement was used to close, there is minimal breast parenchyma left at the inferior margin. Advancing this into the lumpectomy cavity does create some distortion along the inframammary fold. Therefore, the breast tissue both above and below the lumpectomy cavity is released from the underlying chest wall. They form a well vascularized broad based pedicle. This is advanced into the lumpectomy cavity and secured together with interrupted 3-0 Vicryl sutures. Approximately 10 sq cm of tissue are mobilized in this fashion. Thank you for your help.

Answer:

No, 14000 ADJACENT TISSUE TRANSFER OR REARRANGEMENT, TRUNK; DEFECT 10 SQ CM is not reported with a partial mastectomy (lumpectomy) code 19301 for a local advancement flap, which is what is described in your question

Elimination of dead space is inherent to a mastectomy procedure. Local advancement flaps and oncoplastic repair are included in a mastectomy procedure.

*This response is based on the best information available as of 10/23/25.

Needle Aspiration of Peritonsillar Abscess: Choosing the Correct CPT Code

Question:

Can you explain Peritonsillar Abscess billing 42700 vs 10160? Can we bill and defend 42700 if a provider does an FNA to evacuate a PTA?

Answer:

When a provider performs fine needle aspiration (FNA) to evacuate a peritonsillar abscess (PTA), the correct CPT code to report depends on the intent and technique of the procedure.

If it is truly a FNA and performed for diagnostic purposes, such as collecting a specimen for cytology or pathology, then CPT 10021 (Fine needle aspiration biopsy, without imaging guidance; first lesion) is appropriate.

If the provider uses a needle to evacuate pus from a peritonsillar abscess then this is considered a therapeutic aspiration, and CPT 10160 (Puncture aspiration of abscess, hematoma, bulla, or cyst) is the correct code.

According to CPT Assistant, February 2008, Volume 18, Issue 2, pages 8–9: "From a CPT coding perspective, an incision must be performed in order for an incision and drainage procedure to be reported; an aspiration procedure does not involve an incision.”

Therefore, CPT 42700, which describes incision and drainage of abscess; peritonsillar, is not appropriate unless an actual incision is made into the PTA. 

*This response is based on the best information available as of 10/23/25.

63047 with 22633 for Interbody Fusion?

Question:

We would like some coding insight from KZA. Can you report CPT code 63047 with 22633 if you append modifier 51 to CPT code 63047 if the documentation supports the work done beyond that required for interbody fusion?

Answer:

Thank you for asking KZA!

CPT 63047 should not be reported with CPT 22633 at the same level/interspace.

Add-on codes (63052 & 63053) exist for decompression at the same level or interspace with a posterior lumbar interbody fusion (22630-22634). Remember, this is for decompression beyond preparation of the interspaces for fusion.

• 63052 – Laminectomy, facetectomy, or foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s] [eg, spinal or lateral recess stenosis]), during posterior interbody arthrodesis, lumbar; single vertebral segment

• 63053 – Laminectomy, facetectomy, or foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s] [eg, spinal or lateral recess stenosis]), during posterior interbody arthrodesis, lumbar; each additional vertebral segment

In the submitted scenario, the appropriate code to report is CPT 63052 if your documentation supports additional decompression.

*This response is based on the best information available as of 10/23/25.

X-Ray Documentation

Question:

Is it required to have the specific x-ray views noted in the documentation or will the code description of the number of views be sufficient?

Answer:

Thank you for asking KZA! The specific views performed must be documented in the radiology findings. The order for the x-ray that contains the description of the number of views ordered, is not sufficient. Best practice wording example: "X-ray of the left knee obtained in AP, lateral, and sunrise views. Findings: Joint space narrowing with osteophyte formation, no acute fracture. Impression: Degenerative joint disease." 

*This response is based on the best information available as of 10/23/25.

Coding for Traumatic Serosal Tear

Question:

How do you recommend coding for a traumatic transverse colon serosal tear? My coder used "repair of transverse colon." I am getting push back because I said it was a clean case (no spillage of GI contents and no contamination." I am told I can't use Clean classification because of how it was coded. Please advise!

Answer:

Serosal tears after trauma are not separately reported. They are included in the primary procedure. The colon was not lacerated/injured and was not repaired so colon repair may not be reported.

*This response is based on the best information available as of 10/23/25.