Cardiology Coding Alert

Toss out 37205-+37208 to make room for new intravascular stent codes.

CPT^® 2014 deleted stent placement codes 37205-37208 and the related radiological supervision and interpretation code 75960. In their place, you have new codes 37236-+37239, which bundle in stent placement, radiological supervision and interpretation, and (if performed) same-vessel angioplasty.

Deleted: These codes will no longer be valid in 2014:

• 37205, Transcatheter placement of an intravascular stent(s) (except coronary, carotid, vertebral, iliac, and lower extremity arteries), percutaneous; initial vessel
• +37206, … each additional vessel (List separately in addition to code for primary procedure)
• 37207, Transcatheter placement of an intravascular stent(s) (except coronary, carotid, vertebral, iliac and lower extremity arteries), open; initial vessel
• +37208, … each additional vessel (List separately in addition to code for primary procedure)
• 75960, Transcatheter introduction of intravascular stent(s) (except coronary, carotid, vertebral, iliac, and lower extremity artery), percutaneous and/or open, radiological supervision and interpretation, each vessel.

Added: As of Jan. 1, 2014, these codes will be available to replace 37205-37208 and 75960:

• 37236, Transcatheter placement of an intravascular stent(s) (except lower extremity, cervical carotid, extracranial vertebral or intrathoracic carotid, intracranial, or coronary), open or percutaneous, including radiological supervision and interpretation and including all angioplasty within the same vessel, when performed; initial artery
• +37237, … each additional artery (List separately in addition to code for primary procedure) (Use with 37236)
• 37238, Transcatheter placement of an intravascular stent(s), open or percutaneous, including radiological supervision and interpretation and including angioplasty within the same vessel, when performed; initial vein
• +37239, … each additional vein (List separately in addition to code for primary procedure) (Use with 37238).

As you review the code definitions, you’ll see that the structure of the new codes differs from what you’re used to for 37205-37208 (see table on next page).

Get the Most From the Guidelines

Many of the stent placement rules you’re already familiar with apply to these codes. Specifically, a single code represents one or more stents placed in a single vessel. Also, if one intervention can treat a single lesion that extends from one vessel to another, use only a single code.

Although these codes incorporate multiple services, don’t miss the codes you may report separately.

• Vascular access ultrasound guidance is separately reportable using +76937 (Ultrasound guidance for vascular access requiring ultrasound evaluation of potential access sites, documentation of selected vessel patency, concurrent realtime ultrasound visualization of vascular needle entry, with permanent recording and reporting [List separately in addition to code for primary procedure]).
• Intravascular ultrasound also may be reported separately (+37250, +37251, Intravascular ultrasound [non-coronary vessel] during diagnostic evaluation and/or therapeutic intervention …).
• Other separately reportable services include mechanical thrombectomy (37184-37188) and thrombolytic therapy (37211-37214).