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Radiology Coding Alert

Reader Question:

Dialysis Graft Thrombolytic Infusion

Question: If our radiologist performs thrombolytic infusion on a dialysis graft for more than one hour (e.g., four hours), should we assign 37201 and 75896 instead of 36870?

Kansas Subscriber
Answer: Duration of the infusion does not affect coding. If thrombolysis is done within the graft, it is considered part of the procedure and reported with 36870 (thrombectomy, percutaneous, arteriovenous fistula, autogenous or nonautogenous graft [includes mechanical thrombus extraction and intra-graft thrombolysis]). Conversely, if the infusion is conducted outside of the graft (e.g., with the outflow veins or the distal artery), 37201 (transcatheter therapy, infusion for thrombolysis other than coronary) and 75896 (transcatheter therapy, infusion, any method [e.g., thrombolysis other than coronary], radiological supervision and interpretation) would be used.
You Be the Coder and Reader Questions were answered by Donna Richmond, RCC, CPC, radiology coding specialist with Acadiana Computer Systems Inc., a medical billing management company based in Lafayette, La., which serves more than 200 radiologists, pathologists and anesthesiologists; and Gary Dorfman, MD, FACR, FSCVIR, past president of the Society for Cardiovascular and Interventional Radiology (SCVIR) and president of Health Care Value Systems in North Kingstown, R.I.