Wiki Acceptable primary px codes to use with add-on 37186

[chelle1]

Hi... our system denied CPT 37186 with primary procedure, CPT 36253. Is there a list of acceptable primary px that 37186 can be used with? CPT book does not say specifically state anything that I could see.

 

[ishtiyaq.ahmad]

Arterial mechanical thrombectomy is considered a " secondary " transcatheter procedure for removal or retrieval of short segments of thrombus or embolus when performed either before or after another percutaneous intervention(eg: percutaneous transluminal balloon angioplasty, stent placement). Secondary mechanical thrombectomy is reported using 37186.

Its not suitable with 36253.

Hope it may help.

 

[Ajesh Kuriakose]

Secondary thrombectomy may be necessary, before definitive therapy of a lesion, if there is fresh thrombus complicating a stenosis (to prevent distal embolization during the definitive therapy such as PTA or stent) and after an intervention, if there is a distal embolus complicating a definitive therapy of a lesion. Secondary arterial mechanical thrombectomy is always performed in conjunction with another intervention (eg, transluminal balloon angioplasty, stent placement, which is reported separately).

 

[thomas7331]

Medicare publishes their list of acceptable primary codes for each add-on code here:

https://www.cms.gov/Medicare/Coding/NationalCorrectCodInitEd/Add-On-Code-Edits.html

Unfortunately, 37186 is designated as having 'contractor defined primary code(s)', so you'll probably need to contact your specific payer to get more information on this one.

 

[chelle1]

Thank you

It was helpful.