# carotid stent coding



## KSNAVELY (Jun 16, 2011)

i need clarification on coding with carotid stenting. i know that if the stent is place in the
internal carotid that every cath placement on that side is included in the 37215 however if the physician indicated a thoracic arch aortography then can i still bill for 75605.26? or is 
this also included in the 37215.


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## dpeoples (Jun 16, 2011)

KSNAVELY said:


> i need clarification on coding with carotid stenting. i know that if the stent is place in the
> internal carotid that every cath placement on that side is included in the 37215 however if the physician indicated a thoracic arch aortography then can i still bill for 75605.26? or is
> this also included in the 37215.



You can bill for the arch aortography, but the cpt code is 75650 not 75605. Also, you may need a modifier 59 depending on your local carrier.

HTH


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## theresa.dix@tennova.com (Jun 17, 2011)

dpeoples said:


> You can bill for the arch aortography, but the cpt code is 75650 not 75605. Also, you may need a modifier 59 depending on your local carrier.
> 
> HTH



Danny,
 I am wondering about the aortic arch angio. My understanding is its bundled unless diagnostic cath is performed of the opposite side of where the stent is placed. If the opposite side is not involved can we bill the 75650? I have print out that tells me no.

Bundled components- on side that the stent is placed


1)cath placement to right common carotid
2)diagnostic imaging of the unilateral right common and cerebral carotid
3)diagnosic imaging of the aortic arch
4)balloon angioplasty -pre&post dilations

what does dr z say?


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## dpeoples (Jun 17, 2011)

theresa.dix@ethc.com said:


> Danny,
> I am wondering about the aortic arch angio. My understanding is its bundled unless diagnostic cath is performed of the opposite side of where the stent is placed. If the opposite side is not involved can we bill the 75650? I have print out that tells me no.
> 
> Bundled components- on side that the stent is placed
> ...



That was true for awhile but the edit was removed in 2009 or 2010, I will try to find the info later.  

from the new (2011) Zhealth Cardiovascular Coding Reference " Arch Angiography (75650) may be separately billable when performed at the time of cervical carotid stent placement. The study must be a complete study and be diagnostic in nature and not recently performed."

So, one *can* bill for the arch study. Whether or not one *should* bill for it depends on the documentation.

HTH


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## theresa.dix@tennova.com (Jun 17, 2011)

dpeoples said:


> That was true for awhile but the edit was removed in 2009 or 2010, I will try to find the info later.
> 
> from the new (2011) Zhealth Cardiovascular Coding Reference " Arch Angiography (75650) may be separately billable when performed at the time of cervical carotid stent placement. The study must be a complete study and be diagnostic in nature and not recently performed."
> 
> ...



Ok. If you can find that let me know I would like to see what it is telling us.

Thank you for the updated information. You can email me with it if you want to.


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## sgochoco (Oct 11, 2011)

*Sgochoco*

There is a cpt rule that says all ipsilateral diagnostic imaging and catheterizations are inclusive of cpt 37215.  Cpt also says that any related S&I imaging is included in 37215.

Susan CPC


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