# new Lower Extremity Intervention codes



## ksschroeder (Mar 16, 2011)

This is a hypothetical scenario.  I am trying to better understand the new LE codes and what is included.

If an angioplasty was done in the fem-pop territory (37224), then catheter advanced to the posterior tibial and thrombectomy done (37184 or 37186), would the additionally selective catheter placement (36247) be additionally reported since it was more selective than the fem-pop angioplasty?  Or, would 36247 not be billable at all on the same side as 37224 since it is in the same vascular family?


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## Jim Pawloski (Mar 17, 2011)

kcassidy said:


> This is a hypothetical scenario.  I am trying to better understand the new LE codes and what is included.
> 
> If an angioplasty was done in the fem-pop territory (37224), then catheter advanced to the posterior tibial and thrombectomy done (37184 or 37186), would the additionally selective catheter placement (36247) be additionally reported since it was more selective than the fem-pop angioplasty?  Or, would 36247 not be billable at all on the same side as 37224 since it is in the same vascular family?



Catheter placement is bundled into the interventional procedure.
HTH,
Jim Pawloski, CIRCC


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## ksschroeder (Mar 17, 2011)

Thank you, Jim, for your response.   In order to be sure I "get it", please let me know if you agree/disagree with the following statement.

Any catheterization from the same access site through which a lower extremity intervention is performed is bundled into the intervention even if the catheterization is MORE selective than where the intervention occurred.  

Thank you.


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## kimcpccircc (Mar 18, 2011)

*cath*

Any cath work done from the same access site is included in the new 37220-37235 codes is correct statement. 

ZHealth Publishing is an excellent resource!

Kim, CPC
(CIRCC training)


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## cmblocher (May 17, 2011)

*bilateral????*

OFF SUBJECT- However curious how all of you are coding bilateral interventions.
Iliac stents in both left/right common iliac arteries. 

37221-50
OR
37221-RT
37221-LT/59


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## Jim Pawloski (May 17, 2011)

cmweyand said:


> OFF SUBJECT- However curious how all of you are coding bilateral interventions.
> Iliac stents in both left/right common iliac arteries.
> 
> 37221-50
> ...



I would use the second option for this.
If you do not have Dr.Z's book, in the CPT book just before the lower extremity revascularization codes, in the green section, does explains the part of losing the selectivity charges when a intervention is performed.

HTH, 
Jim Pawloski


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## jillmtom (May 17, 2011)

I bill the 2nd choice for bilateral for the new endovascular codes.


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