Look for sweeping changes effective Jan. 1.
If your general and vascular surgeons perform transcatheter placement of intravascular stents or retrograde stenting of the carotid or innominate arteries, you need to go to coding school for next year. That’s because with five code deletions and five code additions, CPT® 2014 reworks everything you currently know about reporting these services.
Read on to get the scoop so you’ll be ready when the code changes go into effect on Jan. 1, 2014.
Replace Transcatheter Stent Placement Codes
You’ll no longer use the following five codes beginning the first of next year, because CPT® 2014 deletes them:
In their place, you’ll find the following four new codes:
“You’ll notice that 75960 just goes away, because the new codes include the radiological supervision and interpretation (S&I),” explains Marcella Bucknam, CPC, CPC-I, CCS-P, CPC-H, CCS, CPC-P, COBGC, CCC, audit manager for CHAN Healthcare in Vancouver, Wash.
“Bundling S&I with the intravascular stent codes seems to be in keeping with the recent AMA trend of creating such combination codes for cardiology,” notes Marchelle Cagle, CPC, CPC-I, CMOM, of Alabama-based Cagle Medical Consulting.
Fee alert: “Such codes can be more straightforward to use and understand, but they often result in decreased reimbursement,” Cagle notes.
Other distinctions: Bundling S&I isn’t the only difference between the old and new codes. You can see from the following table that the structure of the new codes differs from what you’re used to for 37205-37208. Study the table to make sure you understand how you’ll use the new codes beginning Jan. 1.
Get the Most From the Guidelines
Many of the stent placement rules you’re already familiar with apply to new codes 37236-+37239. Specifically, a single code represents one or more stents placed in a single vessel. Also, if one intervention can treat a single lesion that extends from one vessel to another, use only a single code.
Although these codes incorporate multiple services, don’t miss the codes you may report separately:
Greet Retrograde Stent Placement
CPT® 2014 introduces a new code to report transcatheter stent placement in either the intrathoracic common carotid artery or innominate artery using an open cervical carotid approach. A major feature of this code is that it is specific to retrograde treatment, which means going against the flow of blood in the vessel. Any angioplasty or radiological guidance required for the service is also included.
The new code is 37217 (Transcatheter placement of an intravascular stent[s], intrathoracic common carotid artery or innominate artery by retrograde treatment, via open ipsilateral cervical carotid artery exposure, including angioplasty, when performed, and radiological supervision and interpretation).
Be sure to keep the following codes off of your 37217 claim when performed on the same side of the body: