Cardiology Coding Alert

Question: My cardiologist accessed the affected popliteal vein through a tiny incision at the patient’s groin. First, they performed a separately reportable venography by injecting contrast material through the incision into the vein to localize the exact site of the clot in the vein. Under fluoroscopic guidance, they inserted a guidewire into the site of occlusion and then threaded a catheter over the guidewire. The catheter they used had a high-speed waterjet at its tip that my cardiologist used to break the clot. They further dissolved the clot with multiple injections of a thrombolytic agent. Finally, my cardiologist removed all instruments and stopped any bleeding by applying pressure at the site of entry. How should I report this service?

Alabama Subscriber

Answer: This is an example of a venous mechanical thrombectomy. You should report 37187 (Percutaneous transluminal mechanical thrombectomy, vein(s), including intraprocedural pharmacological thrombolytic injections and fluoroscopic guidance) for the initial application. If you need to report bilateral venous mechanical thrombectomy your cardiologist performed through a separate site, append modifier 50 (Bilateral procedure) to code 37187.

Don’t miss: You would report 37188 (Percutaneous transluminal mechanical thrombectomy, vein(s), including intraprocedural pharmacological thrombolytic injections and fluoroscopic guidance, repeat treatment on subsequent day during course of thrombolytic therapy) for repeat treatment on a subsequent day during a course of thrombolytic therapy.