Radiology Coding Alert

Test your coding knowledge.  Determine how you would code this situation before looking at the box below for the answer.
Question: A patient was given nitroglycerin via intra-arterial injection, through the Balkan sheath, to prevent vasospasm during an angioplasty procedure. Can I report 37202 in addition to the angioplasty codes?

Washington Subscriber

Answer: No, in this situation the intra-arterial injection is incidental to the angioplasty procedure and is not reported separately with 37202 (transcatheter therapy, infusion other than for thrombolysis, any type [e.g., spasmolytic, vasoconstrictive]).

The scenario describes an injection of nitroglycerin -- a short, single bolus -- while CPT 37202 is defined as an infusion service. An infusion usually reflects a longer period of continuous medication administration. One example of when 37202 would be appropriately reported is the infusion of vasopressin to control a gastrointestinal bleed.

In the scenario described, you should assign only codes that describe the angioplasty itself (e.g., 35473, transluminal balloon angioplasty, percutaneous; iliac with 75978, transluminal balloon angioplasty, venous [e.g., subclavian stenosis], radiological supervision and interpretation).