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CPT 37221 and modifier 50?

  1. #1
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    Question CPT 37221 and modifier 50?
    Medical Coding Books
    Forgive me...new to this area
    "bilateral common iliac artery stents"
    I am using 37221 for the revascularization...the code states "unilateral" but he's doing 2 stents - one on each side of the bifurcation...can I use mod -50?
    Thanks - I need all the help I can get here...
    Lisa Bledsoe, CPC, CPMA

  2. Default
    this is strainght from Z-Helath:

    23. If interventions are performed in the other leg at the same setting, use the same code set, but add modifier -59 to the "other leg" codes (e.g., for bilateral common iliac stent placement, use codes 37221, 37221-59; for right common iliac stent and left common iliac angioplasty, use codes 37221, 37220-59). (Be sure to check NCCI edits to determine which code requires a -59 modifier. These edits were not available at the time of printing for this book.)

  3. #3
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    Default
    Thank you! I was looking at that, but since -50 is ingrained in my brain as bilateral...well, you know what happens when you over-think things!
    Lisa Bledsoe, CPC, CPMA

  4. #4
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    So, paying closer attention to CPT it states "for bifurcation lesions distal to the common iliac origins which require therapy of 2 distinct branches of the iliac or tibial/peroneal vascular territories, a primary code and an add-on code would be used to describe the intervention". I take that to mean I should code 37221 and 37223.
    Lisa Bledsoe, CPC, CPMA

  5. Default
    37223 is each add'l ipsilateral (same) vessel

    If you are doing the RT & LT vessel it would be 37221, and 37221-59

  6. #6
    Location
    Greeley, Colorado
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    Default
    Got it
    Thanks again!!
    Lisa Bledsoe, CPC, CPMA

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