Radiology Coding Alert

Question: How can we report an intravascular ultrasound in the popliteal and femoral arteries? Can these services be reported with other applicable radiological examinations?

New York Subscriber

Answer: For intravascular ultrasound of the popliteal and femoral (non-coronary) vessels, you have the following codes:  

• +37252, Intravascular ultrasound (noncoronary vessel) during diagnostic evaluation and/or therapeutic intervention, including radiological supervision and interpretation; initial noncoronary vessel (List separately in addition to code for primary procedure)
• +37253, … each additional noncoronary vessel (List separately in addition to code for primary procedure).

Count each vessel: Because you report these codes per vessel, you should include all IVUS done in a single vessel during the entire procedure as a single unit.

Key: You need to understand how many units of codes +37252 and +37253 you can report. As the code descriptors indicate, you should use +37252 for the initial or only vessel involved. Subsequently, use one unit of +37253 to report each additional vessel.

Look for primary procedure: Remember that both initial vessel code +37252 and additional vessel code +37253 are add-on codes. Consequently, you must report them in addition to a primary code.

CPT^® does not provide a specific list of applicable primary codes, but likely possibilities include either diagnostic angiography or therapeutic intervention codes. Examples of relevant interventions include “stent or stent graft placement, angioplasty, atherectomy, embolization, thrombolysis, transcatheter biopsy,” according to CPT^® guidelines.

Code for catheterization: Non-selective and/or selective vascular catheterization may be separately reportable with +37252 and +37253. The catheterization codes are reflected in the series: 36000-36248.