Cardiology Coding Alert

Question: Is there a list of appropriate primary codes for IVUS code +37252?

Massachusetts Subscriber

Answer: Because CPT^® does not define the primary codes appropriate for +37252 (Intravascular ultrasound [noncoronary vessel] during diagnostic evaluation and/or therapeutic intervention, including radiological supervision and interpretation; initial noncoronary vessel [List separately in addition to code for primary procedure]), each payer may determine its own list.

Fortunately, NGS, the Part B MAC for Massachusetts has posted a list of appropriate primary codes for +37252:

• Thrombectomy and vascular revision codes 35875-35876, 35879, 35881, 35883-35884
• Mechanical thrombectomy codes 37184-37188
• Transcatheter intravascular stent placement codes 37215-37218, 37236, 37238
• Revascularization (lower extremity) codes 37220-37231.

Caution: Range 37215-37218, listed above, includes 37216. But the Medicare Physician Fee Schedule gives 37216 a status indicator of “N,” identifying it as a noncovered service. So if you report noncovered 37216 as the primary code for +37252, NGS will reject both.

Resource: You can find the listing by going to the NGS website and searching “Codes Billable as Primary to CPT^® Code 37252.”