You should not miss the 'single vessel' exception.
See to it that your surgery practice is all geared up to implement the overhaul of endovascular revascularization coding.
CPT 2011 adds news codes for lower extremity endovascular revascularization, including angioplasty, atherectomy, and stenting.
Here's a lowdown of femoral/popliteal codes 37224-37227.
Master the single code strategy for Fem/Pop Coding
You will need to get familiar with the following new femoral/popliteal service codes and keep in mind that all of the codes consist of angioplasty in the identical vessel when that service is performed:
- Angioplasty: 37224 -
- Atherectomy (and angioplasty): 37225 --...
- Stent (and angioplasty): 37226 -
- Stent and atherectomy (and angioplasty): 37227
Recall: The general rule for 37224-37227 is that you will need to use the 1 code that represents the most intensive service carried out in a single lower extremity vessel. All lesser services are covered in that one code.
For instance: When your surgeon carries out a stent placement atherectomy, and angioplasty in the left popliteal vessel, you should really go for only 37227. This code covers stent placement, atherectomy, and angioplasty. You shouldn't report 37224 (angioplasty), 37225 (atherectomy), or 37226 (stent placement) separately or in addition to 37227 in this particular scenario.
Make use of this territory rule to stay away from denials
The new peripheral revascularization codes (37220-+37235) apply to different 'territories'. Each and every and each territory has its own precise set of recommendations. 37224-37227 fall beneath the femoral/popliteal vascular territory.
Important rule: According to CPT, "the entire femoral/popliteal territory in one particular lower extremity is taken as a single vessel for CPT reporting." So you will need to use a single code even if the surgeon performed various interventions for numerous lesions in the popliteal artery and in the typical, deep, and superficial femoral arteries in the same leg in the course of the same session.
In these scenarios, you will need to code for the most challenging service.
For instance: If the surgeon carries out angioplasty in the left popliteal artery and atherectomy in the left standard femoral, you really should go for only atherectomy code 37225.
Don't forget: The codes are unilateral, meaning they apply to a service on a single side of the physique. According to CPT, if the physician treats the identical territory (such as femoral/popliteal) in both legs at the exact same session, you should go for modifier 59 (Distinct procedural service) to show both legs are involved.
Nonetheless you must watch out for payers' modifier preferences. Some may want you to use modifier 50, modifiers RT and LT or some combination of modifiers for procedures on both legs.
The adjust from component coding
As per CPT guidelines, in addition to the intervention carried out, the codes include things like
- Accessing the vessel
- Catheterizing the vessel selectively
- Crossing the lesion
- Radiological supervision and interpretation for the intervention carried out
- Any embolic protection utilized
- Closure of arteriotomy (incision in the artery)
- Imaging carried out to document the intervention was done.
For instance: Final year, you reported a superficial femoral artery angioplasty via antegrade puncture making use of now deleted code 35474, 36245, and 75962. This year, you need to report only 37224 to cover all of the services.
Don't forget: If the medical doctor performs mechanical thrombectomy, thrombolysis or both, to help restore blood flow to the occluded location, CPT states that you may very well report these services separately.