Ashley Posted Thu 14th of February, 2019 15:33:11 PM
What should the coding be in an ASC setting (POS 24) for the treatment of a solitary central stenosis angioplasty or central stent in the dialysis circuit, since these are add-on codes versus primary codes (36907 and 36908)?
Is this possibly a mistake by CMS, not realizing they don’t have a primary code for a central venous angioplasty associated with the dialysis circuit?
Is this a known issue and are physicians just entering the peripheral angioplasty code as a work around? It kind of makes sense to not have a large technical charge for a central angioplasty once you’ve already done a peripheral angioplasty, as there is no additional set up and considered an add on code they won’t reimburse much for it.
What is your recommendation to get this reimbursed appropriately? Thank you
SuperCoder Answered Fri 15th of February, 2019 08:39:29 AM
Thanks for the question.
The two codes are add-on options +36907 and +36908 for interventions in the central dialysis segment. Code +36907 covers angioplasty, and +36908 covers both angioplasty and stenting. These codes should be used for procedures the surgeon performs through a puncture in the dialysis circuit. If the physician uses a different access, then you’ll need a different code, such as 37238-+37239 for venous stent placement or new codes 37248-+37249 for venous angioplasty.
The primary codes for +36907 and +36908 include 36901-36906. But 36818-36833, which include services such as open arteriovenous graft creation and thrombectomy, are also appropriate primary codes according to CPT® guidelines.
Also, you can refer to the reference article for this.
Hope this helps.