General Surgery Coding Alert

Question: Our surgeon performed an atherectomy in the posterior tibial artery and the tibioperoneal trunk of the left leg. What is the correct way to code this?

Codify Subscriber

Answer: The correct code for this service is single unit of 37229 (Revascularization, endovascular, open or percutaneous, tibial, peroneal artery, unilateral, initial vessel; with atherectomy, includes angioplasty within the same vessel, when performed).

Here’s why: Although CPT® specifies that 37229 is for the “initial vessel” only, the tibioperoneal trunk does not count as a separate vessel. That means you should include treatment of lesions in the trunk in the code for treatment of lesions in the posterior tibial artery. CPT® specifically states this rule in the guidelines for the codes.

You also should not report separate codes for accessing and catheterizing the artery or for radiological supervision and interpretation. CPT® guidelines indicate these services are part of the work represented by 37229. If a physician must perform extensive repair of the artery or replace it, that physician may report that work separately.