Radiology Coding Alert

Question: May I bill for the microspheres placed into the uterine artery for embolization in the office setting?

New Jersey Subscriber

Answer: There is not a separate HCPCS code to report for the microspheres, which the radiologist injects to prevent blood from flowing to the fibroids, causing the fibroids to shrink.

But some non-Medicare payers will allow separate payment for supplies and implantables in the office setting. Because there is not a specific HCPCS devices code, you would report 99070 (Supplies and materials [except spectacles], provided by the physician over and above those usually included with the office visit or other services rendered [list drugs, trays, supplies, or materials provided]). The payer will usually ask for a copy of the invoice before determining the payment level so it can see how much the physician paid for the supply item.

Remember: You should include the full procedure in the all-inclusive code 37210 (Because of the amount of postoperative pain associated with this procedure, the physician is far more likely to perform it in a facility 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 imaging guidance necessary to complete the procedure). where the patient may stay overnight.

Bonus tip: Diagnosis codes your documentation may support for UFE patients include those in the 218.x (Uterine leiomyoma) range, which ICD-9 states includes uterine fibroids, as well as fibromyoma and myoma. Code 617.0 (Endometriosis of uterus) is another common diagnosis associated with this procedure.