Radiology Coding Alert

Question: How can we report when our physician does an angioplasty and vacuum thrombectomy of the inferior vena cava?

Tennessee Subscriber

Answer: It is highly likely that your physician did the angioplasty prior to the mechanical vacuum thrombectomy. You can submit for both these procedures. For angioplasty, you submit codes 35476 (Transluminal balloon angioplasty, percutaneous; venous) and 75978 (Transluminal balloon angioplasty, venous [e.g., subclavian stenosis], radiological supervision and interpretation). For the inferior vena cava mechanical vacuum thrombectomy, the best code that you can submit is 37187 (Percutaneous transluminal mechanical thrombectomy, vein[s], including intraprocedural pharmacological thrombolytic injections and fluoroscopic guidance). This code includes fluoroscopic guidance.

The code explicitly includes thrombolytic injections performed during the procedure and fluoroscopic guidance, but CPT® guidelines state, “Code(s) for catheter placement(s), diagnostic studies, and other percutaneous interventions (e.g., transluminal balloon angioplasty, stent placement) provided are separately reportable.”

Earn for catheter insertion: Check if your physician inserted the catheter into the inferior vena cava. If yes, you report code 36010 (Introduction of catheter, superior or inferior vena cava) for the catheter insertion.