Radiology Coding Alert

Question: Our interventional radiologists have started performing uterine fibroid embolizations. Which diagnosis code should I use for these patients?

Pennsylvania Subscriber

Answer: You should choose the diagnosis based on the fibroid's location:

• Submucous fibroids (218.0, Submucous leiomyoma of uterus) grow from the uterine wall toward the uterine cavity. They are also called intracavitary fibroids.

• Intramural fibroids (218.1, Intramural leiomyoma of uterus) grow within the uterine wall (myometrium). They are also called interstitial fibroids.

• Subserous fibroids (218.2, Subserous leiomyoma of uterus) grow outward from the uterine wall toward the abdominal cavity. They are also called subperitoneal fibroids.

If the physician does not specify the uterine fibroid's location, assign 218.9 (Leiomyoma of uterus, unspecified) as the diagnosis.

CPT note: You'll report this service using the new-for-2007 code 37210 (Uterine fibroid embolization [UFE, embolization of the uterine arteries to treat uterine fibroids, leiomyomata], percutaneous approach inclusive of vascular access, vessel selection, embolization, and all radiological supervision and interpretation, intraprocedural roadmapping, and image guidance necessary to complete the procedure).

The radiologist inserts a catheter through an artery in the leg to the uterine arteries. The physician then inserts tiny particles of plastic or gelatin through the arteries to block the blood flow inside the fibroids. Without blood flow, the fibroids shrink or may even disappear over time.