tci General Surgery Coding Alert - 2014 Issue 6

Reader Question: Check Distinct Procedures for Thrombectomy and Angioplasty

Question: Our vascular surgeon performed a vacuum thrombectomy with angioplasty of the inferior vena cava. Can we bill multiple procedure codes? Tennessee Subscriber Answer: Yes, you’ll require multiple CPT® codes to adequately capture your surgeon’s work in this case.  You should report the inferior vena cava mechanical vacuum thrombectomy using 37187 (Percutaneous transluminal mechanical thrombectomy, vein[s], including intraprocedural pharmacological thrombolytic injections and fluoroscopic guidance). The code explicitly includes thrombolytic injections performed during the procedure and fluoroscopic guidance, but CPT® guidelines state, “Code(s) for catheter placement(s), diagnostic studies, and other percutaneous interventions (e.g., transluminal balloon...

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