Cardiology Coding Alert

Question: My cardiologist recently performed a percutaneous transluminal angioplasty (PTA) and stent in the right iliac artery. Can I bill for the PTA with a noncoronary stent?

Oklahoma Subscriber

Answer: Yes you can, says Terry Fletcher, BS, CPC, CCS-P, a cardiology coding and reimbursement specialist in Laguna Niguel, Calif. The bundling rules for peripheral interventions differ from coronary interventions, and noncoronary stents do not include angioplasties. In this case, 37205 (transcatheter placement of an intravascular stent[s] [non-coronary vessel], percutaneous; initial vessel) should be billed with 35473 (transluminal balloon angioplasty, percutaneous; iliac).

If a radiologist is not present, you should also bill the associated radiology codes for these two procedures: 75962 (transluminal balloon angioplasty, peripheral artery, radiological supervision and interpretation) and 75960 (transcatheter introduction of intravascular stent[s], [non-coronary vessel], percutaneous and/or open, radiological supervision and interpretation, each vessel). Both radiology codes should have modifier -26 (professional component) appended. The S&I [supervision and interpretation] codes are always coded during a non-coronary intervention to show what the physician has imaged during the procedure, Fletcher says, To tell the codes apart, she adds, coders should remember, The S&I codes are what you did, and the procedural codes are how you got there.