Radiology Coding Alert

Question: How can we report the retrieval of an intravascular vena cava filter? Can we report this as foreign body removal from the vena cava?

New Mexico Subscriber

Answer: You report code 37193 (Retrieval [removal] of intravascular vena cava filter, endovascular approach including vascular access, vessel selection, and radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance [ultrasound and fluoroscopy], when performed) for retrieval of intravascular vena cava filter. In the process of retrieval, your physician will locate the filter, collapse the filter into the telescopic retrieval sheath and use a snare to withdraw the filter from the IVC. Your physician may then check for any residual clots in the IVC.

Do not report foreign body removal code: Do not report filter removal with code 37197 (Transcatheter retrieval, percutaneous, of intravascular foreign body [e.g., fractured venous or arterial catheter], includes radiological supervision and interpretation, and imaging guidance [ultrasound or fluoroscopy], when performed). Code 37193 is specific to IVC filters when your physician removes the IVC as a whole from the IVC because the patient no longer needs the filter. Remember, it is inappropriate to report 37197 because a more specific code exists for the removal of filter.

What is inclusive in 31793? The code 37193 is inclusive of several services. These inclusive services include vascular access, vessel selection, and radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance (ultrasound and fluoroscopy), when performed.

Tip: Do not report code 75825 (Venography, caval, inferior, with serialography, radiological supervision and interpretation) when your physician performs an injection to localize the renal veins before deploying the IVC filter. This imaging is also bundled into the codes for IVC filter placement.