Cardiology Coding Alert

Question: Our doctor did an IVC filter placement. The old codes were 37620, 75940. I was wondering if the new code would be 37191-26. Also documented with the filter is venography (75825) and cath intro (36010) with intro sheath extremity venous (36005). Can all of these be used, or is this a bundling issue in 2012?

Codify Member

Answer:You're right that 37191 (Insertion of intravascular vena cava filter, endovascular approach including vascular access, vessel selection, and radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance [ultrasound and fluoroscopy], when performed) is the new IVC filter placement code.

Caution: The code does not take a modifier 26 (Professional component), per the Medicare Physician Fee Schedule.

Code 37191 should capture all of the services you describe. The code includes "endovascular approach including vascular access, vessel selection, and radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance (ultrasound and fluoroscopy), when performed."

Additionally, Correct Coding Initiative (CCI) edits bundle all of the codes you mention into 37191:

• 36005, Injection procedure for extremity venography (including introduction of needle or intracatheter)
• 36010, Introduction of catheter, superior or inferior vena cava
• 75825, Venography, caval, inferior, with serialography, radiological supervision and interpretation.

Old way: In 2011, you reported IVC filter placement with 36010, 37620 (Interruption, partial or complete, of inferior vena cava by suture, ligation, plication, clip, extravascular, intravascular [umbrella device]), and 75940 (Percutaneous placement of IVC filter, radiological supervision and interpretation). Because 37191 includes all of these elements, CPT® 2012 deletes the IVC-specific codes 37620 and 75940.