Neurology & Pain Management Coding Alert

Question: Does CPT include a code for tissue plasminogen activator (TPA)? Our physicians must follow a protocol with stroke patients that states the physician must get TPA activated within three hours after the patient presents to the physician.


Kentucky Subscriber

Answer: Submit 37195 (Thrombolysis, cerebral, by intravenous infusion) for the TPA. If you code for physicians in a teaching facility, remember that a resident might perform the procedure (although the attending physician must order the service). The attending physician must be present during the procedure before you can code under his name.
 
Teaching physician rules do not apply to nonphysician practitioners. If a nurse administers the -push,- you cannot bill the procedure under the physician's name. Instead, the facility will bill for the nurse's service.

Clinical and coding expertise for You Be the Coder and Reader Questions provided by Neil Busis, MD, chief of the division of neurology and director of the neurodiagnostic laboratory at the University of Pittsburgh Medical Center at Shadyside, and clinical associate professor in the department of neurology, University of Pittsburgh School of Medicine; and Laureen Jandroep, OTR, CPC, CCS-P, CPC-H, CCS, director and senior instructor for CRN Institute, an online coding certification training center based in Absecon, N.J.