Remember initial/additional designation
CPT 2011 divides the just-in codes by initial or additional vessel -- each including angioplasty in the same vessel, when the surgeon performs it -- as here:
Initial vessel: The first four codes apply to the initial tibial or peroneal vessel treated in a single leg:
CPT 2011 divides the just-in codes by initial or additional vessel -- each including angioplasty in the same vessel, when the surgeon performs it -- as here:
Initial vessel: The first four codes apply to the initial tibial or peroneal vessel treated in a single leg:
Angioplasty: 37228
Atherectomy (and angioplasty): 37229
Stent (and angioplasty): 37230
Stent and atherectomy (and angioplasty): 37231
Additional vessel: Report the remaining four add-on codes to report services on each additional ipsilateral (same side) vessel treated in the tibial/peroneal territory:
Additional vessel: Report the remaining four add-on codes to report services on each additional ipsilateral (same side) vessel treated in the tibial/peroneal territory:
Angioplasty: +37232
Atherectomy (and angioplasty): +37233
Stent (and angioplasty): +37234
Stent and atherectomy (and angioplasty): +37235
Revascularization general rule: 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.
Count vessels carefully – more so for TP Trunk
The just-in revascularization codes (37220-+37235) apply to different "territories." Each territory has its own specific set of guidelines. Codes 37228-+37235 come under the tibial/peroneal vascular territory.
The tibial/peroneal arteries include anterior tibial (AT), posterior tibial (PT) and peroneal. This means the just-in codes relate to three vessels in each leg for the tibial/peroneal territory. Since you may report one code per vessel, you may use one initial code and up to two add-on codes per leg (for a total of three vessels). The three-vessel approach is somewhat similar to the iliac territory; however differs from the femoral/popliteal territory, which counts as a single vessel for coding.
Master coding for two legs or two territories
The just-in revascularization codes are unilateral, which means they apply to a service on a single side of the body. CPT indicates that if the doctor treats the identical territory in both legs at the same session, you should add modifier 59 (Distinct procedural service) to show both legs are involved.
However, watch out for payers' modifier preferences. Some may prefer you to use modifier 50, modifiers RT and LT or some combination of modifiers for procedures on both legs.
On the contrary, If the surgeon treats more than one territory in the same leg, you should report multiple codes, says CPT.
Consider included services
According to CPT guidelines, the endovascular revascularization codes include these services: accessing and catheterizing the vessel, crossing the lesion, any radiological supervision or embolic protection, arteriotomy closure, and imaging of the completed intervention.
Extras: If the doctor caries out mechanical thrombectomy (such as 37184-+37185, primary, or +37186, secondary), thrombolysis (such as 37201, 75896), or both to restore blood flow to the occluded area, according to CPT, you may report those services separately.
Article Source :- http://www.supercoder.com/coding-newsletters/my-general-surgery-coding-alert/cpt-2011-37228-37235-4-steps-garner-tp-trunk-services-pay-article
Revascularization general rule: 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.
Count vessels carefully – more so for TP Trunk
The just-in revascularization codes (37220-+37235) apply to different "territories." Each territory has its own specific set of guidelines. Codes 37228-+37235 come under the tibial/peroneal vascular territory.
The tibial/peroneal arteries include anterior tibial (AT), posterior tibial (PT) and peroneal. This means the just-in codes relate to three vessels in each leg for the tibial/peroneal territory. Since you may report one code per vessel, you may use one initial code and up to two add-on codes per leg (for a total of three vessels). The three-vessel approach is somewhat similar to the iliac territory; however differs from the femoral/popliteal territory, which counts as a single vessel for coding.
Master coding for two legs or two territories
The just-in revascularization codes are unilateral, which means they apply to a service on a single side of the body. CPT indicates that if the doctor treats the identical territory in both legs at the same session, you should add modifier 59 (Distinct procedural service) to show both legs are involved.
However, watch out for payers' modifier preferences. Some may prefer you to use modifier 50, modifiers RT and LT or some combination of modifiers for procedures on both legs.
On the contrary, If the surgeon treats more than one territory in the same leg, you should report multiple codes, says CPT.
Consider included services
According to CPT guidelines, the endovascular revascularization codes include these services: accessing and catheterizing the vessel, crossing the lesion, any radiological supervision or embolic protection, arteriotomy closure, and imaging of the completed intervention.
Extras: If the doctor caries out mechanical thrombectomy (such as 37184-+37185, primary, or +37186, secondary), thrombolysis (such as 37201, 75896), or both to restore blood flow to the occluded area, according to CPT, you may report those services separately.
Article Source :- http://www.supercoder.com/coding-newsletters/my-general-surgery-coding-alert/cpt-2011-37228-37235-4-steps-garner-tp-trunk-services-pay-article
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