Wiki CPT 37221 and modifier 50?

[Lisa Bledsoe]

Forgive me...new to this area
"bilateral common iliac artery stents"
I am using 37221 for the revascularization...the code states "unilateral" but he's doing 2 stents - one on each side of the bifurcation...can I use mod -50?
Thanks - I need all the help I can get here...

 

[kbazarte@yahoo.com]

this is strainght from Z-Helath:

23. If interventions are performed in the other leg at the same setting, use the same code set, but add modifier -59 to the "other leg" codes (e.g., for bilateral common iliac stent placement, use codes 37221, 37221-59; for right common iliac stent and left common iliac angioplasty, use codes 37221, 37220-59). (Be sure to check NCCI edits to determine which code requires a -59 modifier. These edits were not available at the time of printing for this book.)

 

[Lisa Bledsoe]

Thank you! I was looking at that, but since -50 is ingrained in my brain as bilateral...well, you know what happens when you over-think things!

 

[Lisa Bledsoe]

So, paying closer attention to CPT it states "for bifurcation lesions distal to the common iliac origins which require therapy of 2 distinct branches of the iliac or tibial/peroneal vascular territories, a primary code and an add-on code would be used to describe the intervention". I take that to mean I should code 37221 and 37223.

 

[kbazarte@yahoo.com]

37223 is each add'l ipsilateral (same) vessel

If you are doing the RT & LT vessel it would be 37221, and 37221-59

 

[Lisa Bledsoe]

Got it
Thanks again!!