Radiology Coding Alert

Question: May I report uterine embolization services more than once per session if the radiologist treats the right and left sides?

Montana Subscriber

Answer: No. You should report one unit of 37210 (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) per patient encounter.

The Medicare physician fee schedule lists 37210 with bilateral indicator "0," which means the bilateral (150 percent) payment adjustment doesn't apply. If you report the procedure with modifier 50 (Bilateral procedure) or with modifiers RT (Right side) and LT (Left side), the payer will "base payment for the two sides on the lower of: (a) the total actual charge for both sides or (b) 100 percent of the fee schedule amount for a single code" (Medicare Claims Processing Manual, chapter 23, http://www.cms.hhs.gov/manuals/downloads/clm104c23.pdf).

Remember: Code 37210 includes catheter placement (selective and nonselective) and imaging. According to CPT guidelines with 37210, that means you shouldn't report the following codes with 37210:

• 36200 -- Introduction of catheter, aorta

• 36245-36248 -- Selective catheter placement, arterial system ...

• 37204 -- Transcatheter occlusion or embolization, percutaneous, any method, non-central nervous system, non-head or neck

• 75894 -- Transcatheter therapy, embolization, any method, radiological supervision and interpretation

• 75898 -- Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion.

Payment for 37210 is less than you received when you reported all the component parts. But "code 37210 has been valued to include the work of the embolization, selective catheterization, and radiologic supervision and interpretation," states the AMA's CPT Changes 2007: An Insider's Guide.

-- The answers for You Be the Coder and Reader Questions were reviewed by Jackie Miller, RHIA, CPC, senior consultant with Coding Strategies Inc. in Powder Springs, Ga.