Wiki Stab Phlebectomy HELP

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Are any of you receiving payment from Novitas without sending an Op Report? My understanding if you use 37765 with a 52 modifier it would be the same as 37799? Is that correct?
 
margetta said:
Are any of you receiving payment from Novitas without sending an Op Report? My understanding if you use 37765 with a 52 modifier it would be the same as 37799? Is that correct?
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I've not heard of billing it like that & we always have to send in the report.
 
The CPT guidelines underneath codes 37765 and 37766 state to report a stab phlebectomy with less than 10 incisions, code CPT 37799. So I have coded this procedure with the unlisted code in the past and would continue to do so since this instruction is still in place in CPT 2020.

Anytime you bill an unlisted code, the insurance company will request an operative report so this is a typical part of the process. As long as the operative report has a description of the procedure including the number of incisions and a diagnosis supporting medical necessity (not a cosmetic procedure) you should be able to support the request for payment with the documentation.

Kim
www.codingmastery.com
 
Guidelines for Reporting Codes 37765 and 37766

from CPT assistant August 2006 page: 6

Codes 37765 and 37766 describe stab phlebectomy of varicose veins in one extremity. Stab phlebectomy involves multiple incisions, and code assignment is based upon the number of stab incisions performed. Code 37765 should be reported when 10 to 20 incisions are made, and code 37766 should be reported when more than 20 incisions are made. In an instance when less than 10 incisions are made, code 37799, Unlisted procedure, vascular surgery, should be reported. It would not be appropriate to report code 37765 with modifier 52, Reduced services, appended when less than 10 incisions are made. Codes 37765 and 37766 are unilateral codes; therefore, in the rare case when stab phlebectomy is performed on both legs, modifier 50, Bilateral procedure, should be appended to the code.
CPT® Assistant copyright 1990-2023 American Medical Association. All rights reserved.
 
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