AHA Coding Clinic® for HCPCS - 2015 Issue 4; Ask the editor
HeRO graft implantation
In Coding Clinic for HCPCS, Fourth Quarter 2012, page 9, coding guidance was provided on the implantation of a HeRO Graft. It was stated to assign CPT code 37799, Unlisted procedure, vascular surgery, for the procedure performed and for OPPS reporting, assign HCPCS code C1750, Catheter, hemodialysis/peritoneal, long term, as an additional code to capture the device utilized. However, in the January 2015 issue of the CPT Assistant on page 13 it states that the HeRO graft would be appropriately reported with CPT code 36830, Creation of arteriovenous fistula by other than direct arteriovenous anastomosis (separate procedure); nonautogenous graft, (eg, biological collagen, thermoplastic graft), and CPT code 36558, Insertion of tunneled centrally inserted central venous catheter, without subcutaneous port or pump; age 5 years or older. Can the advice provided be revised based on the coding guidance provided in the January 2015 CPT Assistant? ...
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Article Overview
This premium article is for coders, CDI professionals, and billing staff who need to understand published guidance related to HeRO graft implantation. It summarizes how the topic has been addressed in official coding publications, including discussion of the relevant procedure reporting framework and device-related reporting for OPPS, while highlighting that later guidance differs from earlier advice. The article is useful when researching whether the procedure falls within vascular surgery, dialysis access, or other cardiovascular coding workflows and when checking which code sets are implicated by the published sources.
Why This Topic Matters
HeRO graft implantation has been addressed in more than one official coding source, and the guidance is not identical. Reviewing the article helps readers identify which code sets are discussed and understand the scope of the published commentary before coding or auditing a case.
Article Sections
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Coding Clinic for HCPCS guidance
This section summarizes an earlier official coding publication that addresses reporting for the implantation procedure and related device reporting considerations for hospital outpatient settings.
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CPT Assistant guidance
This section presents later CPT Assistant commentary on the same procedure topic and places it alongside the earlier HCPCS-related guidance.
What You Will Learn
- Which official coding publications address HeRO graft implantation
- Which code sets are referenced in the published guidance
- How the article frames differences between earlier and later guidance
- What general reporting areas are implicated by the procedure topic
Who Should Read This
- Medical coders
- Outpatient hospital billers
- Compliance and audit staff
- Clinical documentation specialists
- Revenue cycle professionals
Codes Discussed
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