Cardiology Coding Alert

Question: One of our new cardiologists will be performing carotid angioplasty and stents. Which CPT codes should I report? Is the procedure approved by Medicare?

New Jersey Subscriber
 
Answer: Medicare has not approved carotid artery stenting for payment. You can submit claims for these services if your physician is an investigator in an approved trial. In that case, you append HCPCS modifier -QA (FDA investigational device exemption) to the codes and include the investigational device exemption number in block 23 of the claim form (or electronic equivalent). The codes you use vary from carrier to carrier.
 
For instance, Empire Medicare Services, New Jersey's Medicare carrier, indicates in its local medical review policy for carotid artery stenting that you can report 35475 (Transluminal balloon angioplasty, percutaneous; brachiocephalic trunk or branches, each vessel) for the procedure and 75962 (Transluminal balloon angioplasty, peripheral artery, radiological supervision and interpretation) for the radiological S&I, but lists specific guidelines for reporting these codes.