Cardiology Coding Alert

Question: How should I code placement of an infusion catheter in the left lower extremity with administration of TPA? Last year I used 37201, 75896-26, and 36140.

Codify Member

Answer: In 2013, you should choose from 37211-37214, which include thrombolysis, imaging supervision and interpretation (S&I), and other services specified in the code definitions and guidelines. Based on the information given, the code appropriate for your case (artery, initial day) appears to be 37211 (Transcatheter therapy, arterial infusion for thrombolysis other than coronary, any method, including radiological supervision and interpretation, initial treatment day).

As stated above, 37211 includes S&I, so you should not report it separately. In fact, CPT^® revised 75896 for 2013 to specifically state it is not appropriate for thrombolysis: Transcatheter therapy, infusion, other than for thrombolysis, radiological supervision and interpretation.

Regarding use of 36140 (Introduction of needle or intracatheter; extremity artery) or a more selective catheterization code, CPT^® guidelines state that “Code(s) for catheter placement(s), diagnostic studies, and other percutaneous interventions (e.g., transluminal balloon angioplasty, stent placement) provided may be separately reportable.”