Neurology & Pain Management Coding Alert

Question: I need to know if there is a specific CPT code for intravenous administration of t-PA. In a 1996 CPT coding guide for stroke, we were told to use 37201 (transcatheter therapy, infusion for thrombolysis other than coronary). Has a specific code been established for this procedure?

Denise McFerrin
Department of Neurology, Medical College of GA

Answer: Code 37201 is not correct for IV administration of t-PA. That code represents a procedure for actually moving a catheter through the vascular system to the location of the blockage and injecting a thrombolytic agent directly at the site of the clot.

Code 37195 is the code for cerebral thrombolysis by intravenous infusion. Medicare Part B does not pay for CPT code 37195 because it usually is administered by nursing staff in an inpatient or outpatient hospital area. Neurologists time spent supervising the performance of this procedure is included in the evaluation and management service performed. Most other major insurance carriers have adopted this policy as well. Neurologists should check with their carriers in advance before billing for this procedure.