# Embolization - How will you code for bilateral



## Anug123 (Aug 25, 2009)

Hi all,


How will you code for bilateral gonadal vein embolization.. I believe that embolization codes can be coded only once per operative field except for lungs, kidneys.  Please clarify

Thanks
Prabhavathi


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## msncoder (Aug 25, 2009)

You are correct, it is per operative field.


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## Anug123 (Aug 25, 2009)

Thank you

Prabhavathi


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## krishna.k (Sep 8, 2009)

Hi All,

Assign embolization codes 75894 and 37204 twice for left and right.Per sept1998CPT assistant vignette # 2 says different anatomic site (operative field) code twice.

Regds,
Krishna


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## davidzielske (Sep 8, 2009)

Embolization is coded per surgical site, however, as the gonadal veins are unilateral stuctures (such as renal arteries are unilateral structures) the right and the left gonadal veins are treated as two separate surgical sites (as would two kidneys).  If bilateral gonadal vein embolization is performed, it is billed twice with 37204, 37204-59, 75894, 75894-59. (Be aware that it is actually unusual to have bilateral varicocoeles as a problem in men.  Usually the problem is that where the left gonadal vein comes off it is "kinked" resulting in increased pressure below that point, thus, the dilated veins extending into the scrotum called a varicocoele.)  The CPT reference has already been quoted in an earlier response.


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## dpeoples (Sep 8, 2009)

davidzielske said:


> Embolization is coded per surgical site, however, as the gonadal veins are unilateral stuctures (such as renal arteries are unilateral structures) the right and the left gonadal veins are treated as two separate surgical sites (as would two kidneys).  If bilateral gonadal vein embolization is performed, it is billed twice with 37204, 37204-59, 75894, 75894-59. (Be aware that it is actually unusual to have bilateral varicocoeles as a problem in men.  Usually the problem is that where the left gonadal vein comes off it is "kinked" resulting in increased pressure below that point, thus, the dilated veins extending into the scrotum called a varicocoele.)  The CPT reference has already been quoted in an earlier response.



Thank you for this insight, it is very helpful.


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## Anug123 (Sep 8, 2009)

Hi all,

Thanks for your suggestion...again what about 75898?  Do we need to code twice with 59 modifier  Except for cerebral followups.. we usually code it once.. since two vessels were embolized can I code it twice.

Please explain...


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## dpeoples (Sep 9, 2009)

prabhavathi said:


> Hi all,
> 
> Thanks for your suggestion...again what about 75898?  Do we need to code twice with 59 modifier  Except for cerebral followups.. we usually code it once.. _since two vessels were embolized can I code it twice._Please explain...




Yes, you can.


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