Radiology Coding Alert

Question: Our physician removed a broken stent through the cutaneous route. How can we code for this procedure? This procedure involved a catheter. Can we report for the catheter separately?

New York Subscriber

Answer: A broken stent is considered as an intravascular foreign body. You should submit a code for percutaneous retrieval of intravascular foreign body for this procedure. The best code is 37197 (Transcatheter retrieval, percutaneous, of intravascular foreign body [e.g., fractured venous or arterial catheter], includes radiological supervision and interpretation, and imaging guidance [ultrasound or fluoroscopy], when performed). Your physician will use a snare to retrieve the broken stent through the catheter. 

You should report the appropriate catheter placement code depending upon where in the arterial tree your physician placed the catheter and what route was adopted to advance the catheter. Since you haven’t provided these details, it would not be possible to guide you to a specific code. 

Additional tips:

• Do not submit 37197 for inferior venacava filter removal. Look at 37193 for this procedure (Retrieval [removal] of intravascular vena cava filter, endovascular approach including vascular access, vessel selection, and radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance [ultrasound and fluoroscopy], when performed).

• There is no S&I component for 37197.

• Do not submit code +76937 (Ultrasound guidance for vascular access requiring ultrasound evaluation of potential access sites, documentation of selected vessel patency, concurrent realtime ultrasound visualization of vascular needle entry, with permanent recording and reporting [List separately in addition to code for primary procedure]) if it is necessary to use ultrasound guidance to gain vascular access to guide and perform the intravascular foreign body retrieval.