Tag Archives: Closure

Facing denials on your tibial/peroneal codes? No worries, help is at hand.

The new tibial/peroneal service codes are below. Note that all of the codes include angioplasty in the same vessel when that service is performed.

The first four codes apply to the initial tibial or peroneal vessel treated in a single leg:

• Angioplasty: 37228 — Revascularization, endovascular, open or percutaneous, tibial/peroneal artery, unilateral, initial vessel; with transluminal angioplasty
• Atherectomy (and angioplasty): 37229 — … with atherectomy, includes angioplasty within the same vessel, when performed
• Stent (and angioplasty): 37230 – … with transluminal stent placement(s), includes angioplasty within the same vessel, when performed
• Stent and atherectomy (and angioplasty): 37231 — … with transluminal stent placement(s) and atherectomy, includes angioplasty within the same vessel, when performed.

The final four codes are add-on codes that you use to report services on each additional ipsilateral (same side) vessel treated in the tibial/peroneal territory:

The general rule for the revascularization codes is that you should report the one code that represents the most intensive service performed in a single lower extremity vessel. All lesser services in that vessel are included in that one code.

Note that CPT guidelines state that –” in addition to the intervention performed –” the codes include:

• Accessing the vessel
• Selectively catheterizing the vessel
• Crossing the lesion
• Radiological supervision and interpretation for the intervention performed
• Any embolic protection used
• Closure of arteriotomy (incision in the artery)
• Imaging performed to document the intervention was completed.

But remember that if the physician performs mechanical thrombectomy (such as 37184-+37185, primary, or +37186, secondary), thrombolysis (such as 37201, 75896), or both, to help restore blood flow to the occluded area, CPT states you may report those services separately.

The new revascularization codes (37220-+37235) apply to different “territories.” Each…

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Facing denials on your tibial/peroneal codes? No worries, help is at hand.

The new tibial/peroneal service codes are below. Note that all of the codes include angioplasty in the same vessel when that service is performed.

The first four codes apply to the initial tibial or peroneal vessel treated in a single leg:

• Angioplasty: 37228 — Revascularization, endovascular, open or percutaneous, tibial/peroneal artery, unilateral, initial vessel; with transluminal angioplasty
• Atherectomy (and angioplasty): 37229 — … with atherectomy, includes angioplasty within the same vessel, when performed
• Stent (and angioplasty): 37230 – … with transluminal stent placement(s), includes angioplasty within the same vessel, when performed
• Stent and atherectomy (and angioplasty): 37231 — … with transluminal stent placement(s) and atherectomy, includes angioplasty within the same vessel, when performed.

The final four codes are add-on codes that you use to report services on each additional ipsilateral (same side) vessel treated in the tibial/peroneal territory:

The general rule for the revascularization codes is that you should report the one code that represents the most intensive service performed in a single lower extremity vessel. All lesser services in that vessel are included in that one code.

Note that CPT guidelines state that –” in addition to the intervention performed –” the codes include:

• Accessing the vessel
• Selectively catheterizing the vessel
• Crossing the lesion
• Radiological supervision and interpretation for the intervention performed
• Any embolic protection used
• Closure of arteriotomy (incision in the artery)
• Imaging performed to document the intervention was completed.

But remember that if the physician performs mechanical thrombectomy (such as 37184-+37185, primary, or +37186, secondary), thrombolysis (such as 37201, 75896), or both, to help restore blood flow to the occluded area, CPT states you may report those services separately.

The new revascularization codes (37220-+37235) apply to different “territories.” Each…

Continue reading →