Wiki Peripheral infusion coding?

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hencked

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During a difficult case my physician placed SFA and popliteal stents, code 37226. During the course of the case, the profunda femoris was also occluded and TPA was directly infused into this vessel. It was given during the case but was unsuccesful in removing the thrombus. My question is, can I bill 37201 and 75896? The infusion was not continued beyond the end of the case, so it is not prolonged infusion. Does it matter how long it is done in order to be able to bill these codes or in this case of short infusion attempted during the case and not successful, is it considered just an integral part of the procedure?

Just not sure if I should be billing these codes and any help would be appreciated.
 
hencked said:
During a difficult case my physician placed SFA and popliteal stents, code 37226. During the course of the case, the profunda femoris was also occluded and TPA was directly infused into this vessel. It was given during the case but was unsuccesful in removing the thrombus. My question is, can I bill 37201 and 75896? The infusion was not continued beyond the end of the case, so it is not prolonged infusion. Does it matter how long it is done in order to be able to bill these codes or in this case of short infusion attempted during the case and not successful, is it considered just an integral part of the procedure?

Just not sure if I should be billing these codes and any help would be appreciated.
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I am not sure about the length of time, but if this was a separate infusion( not injection) to break up a clot it would seem it fits the script for infusion code 37201-75895 And remember followup angiography (75898) IS separately billed when performed with infusion therapy.
 
So, if it was an injection it is not billable is what I assume you are saying. I will have to check with my physician to clarify that detail. Thanks for the information.
 
hencked said:
So, if it was an injection it is not billable is what I assume you are saying. I will have to check with my physician to clarify that detail. Thanks for the information.
Click to expand...

To charge for thrombolytic infusion, it needs to be infused over one hour to code 37201/75896. An injection is not billable.
HTH,
Jim Pawloski, CIRCC
 
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