Cardiology Coding Alert
Search for IVC Thrombectomy
Question: How should I report vacuum thrombectomy of the IVC with angioplasty of the IVC?
Codify Subscriber
Answer: You should report the inferior vena cava (IVC) mechanical vacuum thrombectomy using 37187 (Percutaneous transluminal mechanical thrombectomy, vein[s], including intraprocedural pharmacological thrombolytic injections and fluoroscopic guidance).
The code explicitly includes thrombolytic injections performed during the procedure and fluoroscopic guidance, but CPT® guidelines state, “Code(s) for catheter placement(s), diagnostic studies, and other percutaneous interventions (e.g., transluminal balloon angioplasty, stent placement) provided are separately reportable.”
For catheter insertion in the IVC, report 36010 (Introduction of catheter, superior or inferior vena cava). Report the angioplasty using 35476 (Transluminal balloon angioplasty, percutaneous; venous) and 75978 (Transluminal balloon angioplasty, venous [e.g., subclavian stenosis], radiological supervision and interpretation). If you’re reporting only the physician’s services, add modifier 26 (Professional component) to 75978.
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