Cardiology Coding Alert

Question: I'm trying to find the code specific to "thrombectomy, left SFA AngioJet." Is +92973 OK for a noncoronary vessel?

New Hampshire Subscriber

Answer: No. Code +92973 (Percutaneous transluminal coronary thrombectomy [List separately in addition to code for primary procedure]) is specific to coronary procedures. For AngioJet thrombectomy in a peripheral vessel, you should consider mechanical thrombectomy codes 37184-37188.

Primary: For superficial femoral artery (SFA) primary thrombectomy, use 37184 (Primary percutaneous transluminal mechanical thrombectomy, noncoronary, arterial or arterial bypass graft, including fluoroscopic guidance and intraprocedural pharmacological thrombolytic injection[s]; initial vessel). According to CPT guidelines, a "primary" thrombectomy involves "pretreatment planning, performance of the procedure, and postprocedure evaluation focused on providing the service." Usually the physician has already diagnosed the thrombus and planned the treatment. The cardiologist may perform other interventions at the same encounter.

Secondary: In contrast, a "secondary" arterial thrombectomy involves "removal or retrieval of short segments of thrombus or embolus when performed either before or after another percutaneous intervention." You'd report a secondary arterial thrombectomy using +37186 (Secondary percutaneous transluminal thrombectomy [e.g., nonprimary mechanical, snare basket, suction technique], noncoronary, arterial or arterial bypass graft, including fluoroscopic guidance and intraprocedural pharmacological thrombolytic injections, provided in conjunction with another percutaneous intervention other than primary mechanical thrombectomy [List separately in addition to code for primary procedure]).

You may see your cardiologist's documentation support secondary thrombectomy more often because the cardiologist may identify the need for the procedure at the start of a planned intervention.