Radiology Coding Alert

Question: Our radiologist wants to code twice when he embolizes the right bronchial artery for a right lung tumor and the left bronchial artery for a left lung tumor. I know we can only bill once when we embolize the uterine arteries. Does the same coding rule apply to the bron-chial embolizations?

Pennsylvania Subscriber

Answer: Not in this case. The right and left bronchial arteries supply the right and left lungs, which are two separate surgical or operative fields, as opposed to the right and left uterine arteries, which supply the same end organ (and would therefore be considered a single operative field). Because your radiologist embolized the separate bronchial arteries to treat separate conditions (two separate tumors), you can bill twice for this procedure.
 
Therefore, for your radiologist's bilateral bronchial artery embolotherapy, you should report two units of 37204 (Transcatheter occlusion or embolization [e.g., for tumor destruction, to achieve hemostasis, to occlude a vascular malformation], percutaneous, any method, non-central nervous system, non-head or neck).
 
You should use the appropriate bilateral modifier, such as modifier -50 (Bilateral procedure) or modifiers -LT (Left side) and -RT (Right side), depending on your payer's preference.
 
In addition, you should report radiological supervision and interpretation (RS&I) code 75894 (Transcatheter therapy, embolization, any method, radiological supervision and interpretation) twice.