Radiology Coding Alert

Question: Can I charge for nitroglycerin injections x 2 when performing a right angioplasty posterior tibial and right peroneal angioplasty? If so, which codes do I use for the full service?

Codify Member

Answer: You should not code separately for nitroglycerin injections during catheter services. The injections are a usual part of the procedure and should not be reported with their own codes.

Caution: Some coders are tempted to report 37202 (Transcatheter therapy, infusion other than for thrombolysis, any type [e.g., spasmolytic, vasoconstrictive]) for these nitroglycerin bolus injections. But you should reserve 37202 for "prolonged infusions into peripheral arteries," according to CPT® Assistant (April 1998).

For the right posterior tibial and right peroneal angioplasty, you should report:

• Vessel 1: 37228, Revascularization, endovascular, open or percutaneous, tibial, peroneal artery, unilateral, initial vessel; with transluminal angioplasty
• Vessel 2: +37232, Revascularization, endovascular, open or percutaneous, tibial/peroneal artery, unilateral, each additional vessel; with transluminal angioplasty (List separately in addition to code for primary procedure).

For coding purposes, CPT® counts the posterior tibial and the peroneal as separate vessels in the same vascular territory. As a result, you may report each intervention in this case separately. You should use the "each additional vessel" code for the second vessel.