# tPA injection during LE recanalization



## Robbin109 (Oct 9, 2012)

Can you bill for injection of tPA:

Pt had a LE angio and atherectomy and then:

"the patient was additionally given intre-arterial tPA intra-arterial verapamil, and intrea-arterial nitroglycrerin through the balloon and selectively into the posterior tibial artery."

Is this tPA billable at all?


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## jmcpolin (Oct 9, 2012)

37202? A 59 modifier is allowed but what is the medical necessity of doing both?  Usually the injection of Verapamil is 37202 was there vasospasm?


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## Robbin109 (Oct 9, 2012)

I thought the 37202 was for an infusion over several hours or extended period, not for an injection during a procedure?

It was for thrombus, not a vasospam.


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## jmcpolin (Oct 9, 2012)

37201 is to treat thrombolysis and 37202 is to treat vaso spasm 

CPT code 37202, Transcatheter therapy, infusion other than for thrombolysis, any type (eg, spasmolytic, vasoconstrictive), describes an arterial infusion of a nonchemotherapeutic medication directly into an artery to treat the artery for diseases or conditions (eg, vasospasm) other than thrombosis. This code should not be used to report intravenous infusions, arterial push injections, or chemotherapy infusions (96401-96425).

Was it just a push?  Infusion is 30 minutes or longer.


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## Robbin109 (Oct 9, 2012)

It appears to be just a push. 

Thrombus left in AT after Atherectomy in the SFA.  Angioplasty to the AT followed by intra-arterial tPA.


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## Robbin109 (Oct 10, 2012)

Still need help, please


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## kessel (Oct 11, 2012)

I have not ever bill for a push of these 2 medications.  My understanding is that you can only bill if it is a continuous flow or drip threw a catheter.


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## Robbin109 (Oct 11, 2012)

Thank you.


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