Cardiology Coding Alert


Remember Component Coding for IVC Filter

Question: Which codes are appropriate for a Greenfield filter implant?

Minnesota Subscriber

Answer: The Greenfield filter is a common inferior vena cava (IVC) filter. There's more than one component to the placement, so be sure you code only those services your cardiologist performs and documents.

The appropriate surgical code for placement is 37620 (Interruption, partial or complete, of inferior vena cava by suture, ligation, plication, clip, extravascular, intravascular [umbrella device]).

AMA's CPT Assistant (May 2001) states that you also may report 36010 (Introduction of catheter, superior or inferior vena cava) for catheterization performed before IVC filter deployment.

For radiological supervision and interpretation, report 75940 (Percutaneous placement of IVC filter, radiological supervision and interpretation). Remember to append modifier 26 (Professional component) if the cardiologist is not claiming the technical component.

Note that Correct Coding Initiative edits bundle 75825 (Venography, caval, inferior, with serialography,radiological supervision and interpretation) into 75940. "Radiology" section notes for transcatheter procedures (including 75940), state that you may report diagnostic venography separately. But to do so, you must meet the guidelines spelled out in the "Radiology" section notes for veins and lymphatics (such as no prior cath venography is available and the cardiologist bases the decision for the procedure on the diagnostic study, or a prior study isn't adequate because either the patient's condition has changed or the prior study offers poor visualization).

The procedure: The IVC is a major blood vessel that returns blood to the heart from the lower body, and the physician places IVC filters to prevent leg clots from reaching the lungs. The physician uses imaging to position a catheter that allows him to insert the filter.

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