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Radiology Coding Alert

Reader Question:

37215 and 37216 Differ Based on DEP

Published on Mon Jul 02, 2012

Question: How should we code distal embolic protection performed with stenting or angioplasty? Codify Member Answer: Before looking for a way to code distal embolic protection (DEP) separately, ensure that it isn't included in the stenting or angioplasty code. Guideline example: The lower extremity revascularization codes (such as 37220, Revascularization, endovascular, open or percutaneous, iliac artery, unilateral, initial vessel; with transluminal angioplasty) include embolic protection based on the CPT® guidelines. That means you should not report DEP separately. Code example: Certain services have codes that differ based on whether DEP is used, so you should simply choose the code that includes protection. For example, you may need to choose between these two: 37215, Transcatheter placement of intravascular stent(s), cervical carotid artery, percutaneous; with distal embolic protection 37216, ... without distal embolic protection. Policy example: Payers may include the placement in related services. For instance, Part B MAC National Government Services (NGS) [...]
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