Cardiology Coding Alert

Question: Our cardiologists have been talking about ultrafiltration in congestive heart failure patients. How would we code this?

Pennsylvania Subscriber

Answer:There is no code that specifically describes this service, so an unlisted procedure code is your best option. Experts advise the use of 37799 (Unlisted procedure, vascular surgery).

As always, you should check your specific payer policies for their particular guidance. For instance, Novitas Medicare’s coding article A51037 for Pennsylvania identifies 90999 (Unlisted dialysis procedure, inpatient or outpatient) as the appropriate code for their Part B providers.

Keep in mind, the patient is likely to undergo ultrafiltration, which can take eight hours or more, in a facility setting. In that case, facility staff would perform the actual work of connecting the patient to the device that removes the excess fluid and the work of monitoring the patient. Consequently, the facility rather than the physician would report the service. Depending on the services the physician provides, an E/M code may be appropriate.

Final note: Many insurance companies consider this procedure to be investigational. Experts strongly advise requesting prior approval before providing the ultrafiltration (also known as aquapheresis) service.