General Surgery Coding Alert

Use flow chart to ease transition to 2011 codes.

Applying a new coding system can be confusing, and the massive CPT 2011 changes to revascularization coding is no exception. That's why we break down the basics of how to use the following codes with two handy tools:

• 37220 -- Revascularization, endovascular, open or percutaneous, iliac artery, unilateral, initial vessel; with transluminal angioplasty
• 37221 -- ...with transluminal stent placement(s), includes angioplasty within the same vessel, when performed
• +37222 -- Revascularization, endovascular, open or percutaneous, iliac artery, each additional ipsilateral iliac vessel; with transluminal angioplasty (List separately in addition to code for primary procedure)
• +37223 -- ... with transluminal stent placement(s), includes angioplasty within the same vessel, when performed (List separately in addition to code for primary procedure).

Tool 1 Grants Visual Aid

Look to the following "decision tree" to find a summary of CPT's new iliac revascularization codes. Be sure to read "37220, 37221 Overhaul Your Iliac Vascular Intervention Choices" on page 12 to get more information on these new codes.

Tool 2 Provides 'Included' List

Don't get caught unbundling services when you use codes 37220-+37223 just because you used to separately report ancillary. CPT 2011 guidelines explain that -- in addition to the intervention performed -- the new codes for iliac artery revascularization include:

• Accessing the vessel
• Selectively catheterizing the vessel
• Crossing the lesion
• Radiological supervision and interpretation (RS&I) for the intervention performed
• Any embolic protection used
• Closure of arteriotomy (incision in the artery)
• Imaging performed to document the intervention was completed.

Report separately: If the surgeon performs mechanical thrombectomy (such as +37186), thrombolysis (such as 37201, 75896), or both, to help restore blood flow to the occluded area, CPT states you may report those services separately.