Radiology Coding Alert

Question: What codes should I report when the physician uses ultrasonic guidance to map and locate leg veins and provide guidance for a laser ablation catheter?


Wyoming Subscriber

Answer: Assuming the doctor only treats one incompetent vein, you should report 36478 (Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, laser; first vein treated).

You shouldn't report the imaging guidance separately because the 36478 descriptor specifies that the code includes all imaging guidance and monitoring.

If the physician treats another vein in the same leg through a separate access site, you should also report +36479 (... second and subsequent veins treated in a single extremity, each through separate access sites [list separately in addition to code for primary procedure]).

Caution: Codes 36478 and 36479 are specific to laser endovenous ablation. If your physician uses radiofrequency, you should look to 36475 and +36476 (Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency ...) instead.