Use 37202 for Nitroglycerin Injections
Question: Can you charge for nitroglycerin injections x 2 when carrying out a right posterior tibial angioplasty as well as right peroneal angioplasty? If so, which codes do you use for the full service?
Answer: You are not supposed to separately code nitroglycerin injections in catheter services for accurate CPT coding. The injections are a normal part of the procedure and must not be reported with their own codes.
Caution: Some coders wish to report 37202 (Transcatheter therapy, infusion other than for thrombolysis, any type [e.g., spasmolytic, vasoconstrictive]) for these nitroglycerin bolus injections. However, you must reserve 37202 for "prolonged infusions into peripheral arteries," as per CPT® Assistant (April 1998).
For the right posterior tibial and right peroneal angioplasty CPT coding, you should report 37228 (Revascularization, endovascular, open or percutaneous, tibial, peroneal artery, unilateral, initial vessel; with transluminal angioplasty) for one vessel and +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]) for the second vessel.
For CPT coding purposes, CPT® counts the posterior tibial as well as the peroneal as separate vessels in the same vascular territory. So you may report every single intervention in this case separately.
Strengthen Rx Management Documentation
Question: Is there a specific code for writing a prescription?
Answer: As per CPT coding , writing prescriptions are a part of an E/M service. This is just part of the cost of seeing patients, much similar to office supplies. There is no particular code that payers will reimburse for writing a prescription.
Note: In case you review the Table of Risk in the 1995 or year 1997 E/M Documentation Guidelines, you'll see "Prescription drug management" designated as "Moderate" level of risk under "Management Options Selected." This is how prescription drug management can affect your E/M level.
Best possible practice is for the provider to document prescription's actual management. For instance, in case the cardiologist renews a cholesterol-related prescription, the plan of care may maintain that the patient has been bearing the present dosage well and it is keeping her numbers where they are required to be, therefore the physician is now renewing the prescription. As another instance, the physician may state that she's selecting a specific cardiovascular drug as it is safer in combination with the patient's diabetes medication.
Medical Coding and Billing Tip: ICD-9 includes V68.1 (Issue of repeat prescriptions), however you shouldn't report V68.1 with an E/M code in case the only cause the patient comes in is to pick up a prescription. Without face-to-face time and an actual evaluation and management service, you must not bill an E/M code.
Question: Can you charge for nitroglycerin injections x 2 when carrying out a right posterior tibial angioplasty as well as right peroneal angioplasty? If so, which codes do you use for the full service?
Answer: You are not supposed to separately code nitroglycerin injections in catheter services for accurate CPT coding. The injections are a normal part of the procedure and must not be reported with their own codes.
Caution: Some coders wish to report 37202 (Transcatheter therapy, infusion other than for thrombolysis, any type [e.g., spasmolytic, vasoconstrictive]) for these nitroglycerin bolus injections. However, you must reserve 37202 for "prolonged infusions into peripheral arteries," as per CPT® Assistant (April 1998).
For the right posterior tibial and right peroneal angioplasty CPT coding, you should report 37228 (Revascularization, endovascular, open or percutaneous, tibial, peroneal artery, unilateral, initial vessel; with transluminal angioplasty) for one vessel and +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]) for the second vessel.
For CPT coding purposes, CPT® counts the posterior tibial as well as the peroneal as separate vessels in the same vascular territory. So you may report every single intervention in this case separately.
Strengthen Rx Management Documentation
Question: Is there a specific code for writing a prescription?
Answer: As per CPT coding , writing prescriptions are a part of an E/M service. This is just part of the cost of seeing patients, much similar to office supplies. There is no particular code that payers will reimburse for writing a prescription.
Note: In case you review the Table of Risk in the 1995 or year 1997 E/M Documentation Guidelines, you'll see "Prescription drug management" designated as "Moderate" level of risk under "Management Options Selected." This is how prescription drug management can affect your E/M level.
Best possible practice is for the provider to document prescription's actual management. For instance, in case the cardiologist renews a cholesterol-related prescription, the plan of care may maintain that the patient has been bearing the present dosage well and it is keeping her numbers where they are required to be, therefore the physician is now renewing the prescription. As another instance, the physician may state that she's selecting a specific cardiovascular drug as it is safer in combination with the patient's diabetes medication.
Medical Coding and Billing Tip: ICD-9 includes V68.1 (Issue of repeat prescriptions), however you shouldn't report V68.1 with an E/M code in case the only cause the patient comes in is to pick up a prescription. Without face-to-face time and an actual evaluation and management service, you must not bill an E/M code.
