Radiology Coding Alert

Question: Should I code the following report for a patient with a poorly functioning permacatheter using 37201, 75896?

Procedure: 5 mg of TPA were dripped in two divided doses, one through each port of the catheter over a three hour period. Upon completion of the TPA infusion, blood was rapidly aspirated through both ports of the catheter. Both ports were flushed with saline and locked with heparin, 1000 units per cc.

Impression: Status post catheter thrombolysis using a three hour TPA infusion with a total of 5 mg of TPA. Excellent flow was noted in each port of the catheter  upon completion.

California Subscriber

Answer: This procedure gives you the chance to report new-in-2008 code 36593 (Declotting by thrombolytic agent of implanted vascular access device or catheter).

You should not report 37201 (Transcatheter therapy, infusion for thrombolysis other than coronary) and 75896 (Transcatheter therapy, infusion, any method [e.g., thrombolysis other than coronary], radiological supervision and interpretation). These codes describe thrombolytic therapy of a vessel.

Your report describes TPA infusion of a device rather than a vessel.