IVC Filters & Interventions??

camsgram

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Can anyone explain..Filter code 37191 is all inclusive for venography (extremities/IVC), U/S & catheter placement. If an intervention is performed after the filter is placed should the catheter placement, venography & U/S be coded with it?

And if it should be coded, can you please direct me to the guidelines stating that it should.

Thank you.
 

Jim Pawloski

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Can anyone explain..Filter code 37191 is all inclusive for venography (extremities/IVC), U/S & catheter placement. If an intervention is performed after the filter is placed should the catheter placement, venography & U/S be coded with it?

And if it should be coded, can you please direct me to the guidelines stating that it should.

Thank you.

Need more information, what kind of intervention was performed?

Jim Pawloski, CIRCC
 

camsgram

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1. IVC Filter placement
2. Perc Mechanical Thrombectomy, right lower ext DVT
3. Catheter-directed Thrombolysis, right lower ext DVT
4. Catheter placement IVC
5. Right Leg Venogram
6. Inferior Venacavogram
7. U/S guided right popliteal venous access.

Will this help or do you need more of the report info?

I came up with 37191, 37187, 37212.
 

Jim Pawloski

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1. IVC Filter placement
2. Perc Mechanical Thrombectomy, right lower ext DVT
3. Catheter-directed Thrombolysis, right lower ext DVT
4. Catheter placement IVC
5. Right Leg Venogram
6. Inferior Venacavogram
7. U/S guided right popliteal venous access.

Will this help or do you need more of the report info?

I came up with 37191, 37187, 37212.

I would agree with your codes, however I don't see the access site for the filter, going to assume it was jugular access. You can bill 36005 and 75820 for the extremity venogram.
Sorry about getting back to you so late.
Thanks,
Jim Pawloski, CIRCC
 

camsgram

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I appreciate you getting back with me :)

Access was the distal popliteal vein, a venogram was performed and then the IVC was wired for the filter procedure. And then the other interventions were performed. I thought that any/all diagnostic venograms performed were bundled in to the 37191, along with U/S and catheter placement?? Is that not correct?

Thank you for replying I just need an expert's opinion.
 

Jim Pawloski

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I appreciate you getting back with me :)

Access was the distal popliteal vein, a venogram was performed and then the IVC was wired for the filter procedure. And then the other interventions were performed. I thought that any/all diagnostic venograms performed were bundled in to the 37191, along with U/S and catheter placement?? Is that not correct?

Thank you for replying I just need an expert's opinion.

If the ultimate intention was the filter placement, yes the ultrasound, the access, and imaging would be bundled. With the information you gave me, it looks like the filter was being used to prevent any clot in the leg that might come off from the thrombolysis intervention. So you can bill for the venogram, the thrombectomy and the thrombolysis separately, and use modifier -59 for the ivc filter placement.

HTH,
Jim Pawloski, CIRCC
 
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