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37226 and selective cath/procedures

  1. #1
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    Question 37226 and selective cath/procedures
    Medical Coding Books
    If 37226 is performed, and the physician also documents selective catheterization of the anterior tibal, posterior tibial and peroneal vessels for which he infused hepariized saline and then instilled nitroglycerine...well, how would that be coded?
    Lisa Bledsoe, CPC, CPMA

  2. #2
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    Quote Originally Posted by Lisa Curtis View Post
    If 37226 is performed, and the physician also documents selective catheterization of the anterior tibal, posterior tibial and peroneal vessels for which he infused hepariized saline and then instilled nitroglycerine...well, how would that be coded?
    Hi Lisa,
    I check CCI edits, and I think your out of luck. The selectives and nitro are bundled into procedure.
    Have a good week!
    Jim Pawloski, CIRCC

  3. #3
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    Quote Originally Posted by Jim Pawloski View Post
    Hi Lisa,
    I check CCI edits, and I think your out of luck. The selectives and nitro are bundled into procedure.
    Have a good week!
    Jim Pawloski, CIRCC
    Hi Jim - are you using 37202 and 75896? I want to make sure I have those correct, even if I can't report them. However, according to my encoder 37202 can be billed with 37226 if mod -59 is appended. So, now I wonder if I was even on the right track!
    Thanks again for your help and expertise!
    Lisa
    Lisa Bledsoe, CPC, CPMA

  4. #4
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    Quote Originally Posted by Lisa Curtis View Post
    Hi Jim - are you using 37202 and 75896? I want to make sure I have those correct, even if I can't report them. However, according to my encoder 37202 can be billed with 37226 if mod -59 is appended. So, now I wonder if I was even on the right track!
    Thanks again for your help and expertise!
    Lisa
    I would not use 37202 in this case. You use 37202 for a long term infusion of a drug, like urokinase type procedure. Best one that I can think of is using Papaverine in a SMA spasm case, where it is infused through a catheter for a long period of time. The nitro was an injection of a vessel.
    HTH,
    Jim

  5. #5
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    Thank you for that clarification, Jim. What about 96374?
    Lisa Bledsoe, CPC, CPMA

  6. #6
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    Quote Originally Posted by Lisa Curtis View Post
    Thank you for that clarification, Jim. What about 96374?
    I have a problem with the CPT's terminology for the code, but see what the third party payers would do. Anyone else have an opinion?

    Jim

  7. #7
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    It just seems to me that there should be some credit for infusing meds for vasospasm...
    Lisa Bledsoe, CPC, CPMA

  8. #8
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    Quote Originally Posted by Jim Pawloski View Post
    I have a problem with the CPT's terminology for the code, but see what the third party payers would do. Anyone else have an opinion?

    Jim
    This is an interesting question...however, I would not code 37202/75896 for treatment (by a physician) of vasospam during a revascularization procedure since the intervention (37226 etc) includes whatever reasonable work necessary to achieve desired result.

    Also, 96374 is "not intented to be reported by the physician in the facility setting" per cpt description in the instructions at the beginning of section on Therapeutic, Prophylactic and Diagnostic Injections and Infusions. Is this "push" being performed by staff in a hospital?

    This is just my opinion, not my specialty so maybe someone else can chime in with a better response.

    HTH
    Danny L. Peoples
    CIRCC,CPC

  9. #9
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    Thanks to both of you. I am getting a crash course on vascular coding!
    Lisa Bledsoe, CPC, CPMA

  10. #10
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    Quote Originally Posted by dpeoples View Post
    This is an interesting question...however, I would not code 37202/75896 for treatment (by a physician) of vasospam during a revascularization procedure since the intervention (37226 etc) includes whatever reasonable work necessary to achieve desired result.

    Also, 96374 is "not intented to be reported by the physician in the facility setting" per cpt description in the instructions at the beginning of section on Therapeutic, Prophylactic and Diagnostic Injections and Infusions. Is this "push" being performed by staff in a hospital?

    This is just my opinion, not my specialty so maybe someone else can chime in with a better response.

    HTH
    Thanks Danny! I had questions about the use of the code myself. That's why I wanted more opinions.
    Thanks again,
    Jim

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