Placement of IVC filter in the bilateral common iliac

vicwoo

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One of my doctors had planned to place an IVC filter for DVT but after measuring the IVC at greater than 30mm decided to place a IVC filter in both of the patient's commom iliac veins. He wants to code this with 37191-Insertion of intravascular vena cava filter, endovascular approach including vascular access, vessel selection, and radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance (ultrasound and fluoroscopy), when performed, twice for each filter placed, but I do not believe this is correct and the only code I can come up with is the unlisted procedure code for vascular surgery 37799. Can anyone give me any help? Thank you.
 

jewlz0879

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Geez, I despise using unlisted codes but I do see your delimma. Have you checked with Dr. Z to see if there are suggestions for this? I was reading this code in the Igenix Cardiology/Cardiothoracic Surgery/Vascular Surgery 2012 hoping that it would say something about placing other than in the IVC, but no such luck. This might be a stretch but I'm thinking you could still use 37191/37191-59; the description says 'insertion of a vena cava filter' does not say it has to be in the IVC, but yea, it MIGHT be a stretch.
 

donnajrichmond

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One of my doctors had planned to place an IVC filter for DVT but after measuring the IVC at greater than 30mm decided to place a IVC filter in both of the patient's commom iliac veins. He wants to code this with 37191-Insertion of intravascular vena cava filter, endovascular approach including vascular access, vessel selection, and radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance (ultrasound and fluoroscopy), when performed, twice for each filter placed, but I do not believe this is correct and the only code I can come up with is the unlisted procedure code for vascular surgery 37799. Can anyone give me any help? Thank you.
Unlisted 37799 should be used.
 
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