General Surgery Coding Alert

Question: Our surgeon removed a coronary artery stent through a catheter. Should we bill this as 37193?

Illinois Subscriber

Answer: No, you should not report the service as 37193 (Retrieval [removal] 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). This code specifically describes removal of a vena cava filter, not a coronary artery stent.

For the procedure you describe, a better code choice is 37197 (Transcatheter retrieval, percutaneous, of intravascular foreign body [eg, fractured venous or arterial catheter], includes radiological supervision and interpretation, and imaging guidance [ultrasound or fluoroscopy], when performed).

Code 37197 refers to a non-specific intravascular foreign body, which would include a coronary artery stent. Although “stent” is not listed in the parenthetic note, “e.g.” means “for example,” so the listed foreign bodies are examples, not an inclusive list.

Tip: Notice that both 37193 and 37197 state, “includes radiological supervision and interpretation, and imaging guidance (ultrasound or fluoroscopy), when performed.” Even if your surgical note does not document any imaging guidance, you can still report one of these codes, because the code includes guidance when performed, but rightly describes the procedure even if the provider doesn’t use radiological guidance.