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peroneal/tibial PTA AND ATHRECTOMY

Sadia Posted Tue 25th of September, 2012 17:54:06 PM

37229 THE CORRECT CODE AND FOR RADIOLOGY IS 75960 THE CORRECT CODE

SuperCoder Answered Tue 25th of September, 2012 21:43:06 PM

Correct.

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.

Initial vessel: 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.

Additional vessel: 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. Heed the "use with" notes following each descriptor:

Angioplasty: +37232 -- Revascularization, endovascular, open or percutaneous, tibial/peroneal artery, unilateral, each additional vessel; with transluminal angioplasty (List separately in addition to code for primary procedure) (use with 37228-37231)
Atherectomy (and angioplasty): +37233 -- ... with atherectomy, includes angioplasty within the same vessel, when performed (List separately in addition to code for primary procedure) (use with 37229-37231)
Stent (and angioplasty): +37234 -- ... with transluminal stent placement(s), includes angioplasty within the same vessel, when performed (List separately in addition to code for primary procedure) (use with 37230-37231)
Stent and atherectomy (and angioplasty): +37235 -- ... with transluminal stent placement(s) and atherectomy, includes angioplasty within the same vessel, when performed (List separately in addition to code for primary procedure) (use with 37231).
Remember: 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.

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.

75960 will not be coded separately with 37229 here.

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