Tag Archives: Lower Extremity
37228-+37235 Cover Your Tibial/Peroneal Service Codes
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…
37228-+37235 Cover Your Tibial/Peroneal Service Codes
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…
Turn To 37224-37227 For Your Femoral/Popliteal Codes
CPT’s definition of a ‘single vessel’ for this territory is an exception to the rule.
CPT 2011 adds new codes for lower extremity endovascular revascularization covering angioplasty, atherectomy, and stenting, noted Stacy Gregory, CCC, CPC, RCC, of Gregory Medical Consulting Services, in her presentation, “Peripheral Vascular Coding Tactics,” at the 2011 Coding Update and Reimbursement Conference in Orlando (www.codingconferences.com).
This article focuses on the femoral/popliteal codes 37224-37227. “37220 to +37223 Revamp Your Iliac Intervention Coding Options” in Cardiology Coding Alert discussed the iliac codes. Look to a future issue to cover tibial/peroneal codes 37288-+37235.
The new femoral/popliteal service codes are below. Note that all of the codes include angioplasty in the same vessel when that service is performed:
- Angioplasty: 37224 — Revascularization, endovascular, open or percutaneous, femoral/popliteal artery(s), unilateral; with transluminal angioplasty
- Atherectomy (and angioplasty): 37225 — … with atherectomy, includes angioplasty within the same vessel, when performed
- Stent (and angioplasty): 37226 — … with transluminal stent placement(s), includes angioplasty within the same vessel, when performed
- Stent and atherectomy (and angioplasty): 37227 — … with transluminal stent placement(s) and atherectomy, includes angioplasty within the same vessel, when performed.
The general rule for 37224-37227 is that you should report the one code that represents the most intensive service performed in a single lower extremity vessel. All lesser services are included in that one code.
When the cardiologist performs a stent placement, atherectomy, and angioplasty in the left popliteal vessel, you should report only 37227.
That code covers stent placement, atherectomy, and angioplasty. You should not report 37224 (angioplasty), 37225 (atherectomy), or 37226 (stent placement) separately or in addition to 37227 in this scenario.
As explained in the last issue of Cardiology Coding Alert, CPT guidelines state that — in addition to the intervention performed…
CPT 2011: 37220 to +37223 Revamp Interventional Coding
Think outside the box for iliac atherectomy.
Are you ready to apply CPT’s new revascularization codes starting January 1? Check out these six tips to get you on your way.
CPT 2011 offers up new codes to help you report services more accurately, including endovascular revascularization, says Marcella Bucknam, CPC, CCS-P, CPC-H, CCS, CPC-P, COBGC, CCC, manager of compliance education for the University of Washington Physicians Compliance Program in Seattle.
Specifically, CPT 2011 adds several new codes that represent lower extremity endovascular revascularization, meaning angioplasty, atherectomy, and stenting. Here’s how the codes break down:
- Iliac: 37220-+37223– Revascularization, endovascular, open or percutaneous, iliac artery …
- Femoral, popliteal: 37224-37227– Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(s), unilateral …
- Tibial/peroneal: 37228-+37235– Revascularization, endovascular, open or percutaneous, tibial, peroneal artery, unilateral …
In this article, iliac artery services are the focus. Look to future articles to discuss femoral, popliteal, and tibial/peroneal services.
Watch Procedure and Vessel to Choose Among 37220-+37223
The new iliac service codes are as follows:
- 37220– Revascularization, endovascular, open or percutaneous, iliac artery, unilateral, initial vessel; with transluminal angioplasty
- 37221– … with transluminal stent placement(s), includes angioplasty within the same vessel, when performed
- +37222– Revascularization, endovascular, open or percutaneous, iliac artery, each additional ipsilateral iliac vessel; with transluminal angioplasty (List separately in addition to code for primary procedure)
- +37223– … with transluminal stent placement(s), includes angioplasty within the same vessel, when performed (List separately in addition to code for primary procedure).
Reading through the definitions, you see that the codes for iliac services differ based on whether you’re coding a service in an initial vessel or in an additional vessel. Your options also differ based on whether you’re reporting (1) angioplasty alone or…
Diabetic Foot Ulcer Skin Substitutes Require G Codes in 2011
When reporting diabetic foot ulcer treatment involving tissue cultured skin substitutes to the lower extremity for a Medicare beneficiary in 2011, you’ll use two temporary G codes.
Providers were concerned about the different global periods for two t… Continue reading
93451-93464 Will Bulk Up Your Cardiac Cath Coding Options in the New Year
Revascularization, heart catheterization, and more all have new looks in CPT 2011. Here’s an overview of what you can expect.
• 37220-37235: Endovascular revascularization, open or percutaneous
The codes in this range are distinguished by the vesse… Continue reading
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