CPT Coding Guidelines Review: Transcatheter Thrombectomy/Thrombolysis

This is a series of blogs about the importance of being familiar with CPT coding guidelines. Often there is extensive guidance preceding a subsection or range of codes for particular procedures, but coders are very busy so sometimes they jump right into the codes without taking time to review these guidelines, even though following or not following their direction could significantly affect the accuracy and comprehensiveness of coding.

This series is designed to help you become familiar with guidelines for significant procedures that you might not be acquainted with but do impact coding. The presentations are short and meant to generate awareness of the guidelines that are available in CPT rather than the application of guidelines to specific coding scenarios.

This installment of the series explores the guidelines related to CPT coding for transcatheter thrombectomy or thrombolysis.

CPT Guidelines Transcatheter Thrombectomy/Thrombolysis

Please watch this presentation to learn about the guidelines that provide direction in assigning CPT codes for transcatheter thrombectomy and/or thrombolysis.

Take Aways

• Thrombectomies are coded by type of vessel, arterial vs. venous
• Arterial thrombectomy procedures are designated as primary or secondary
• Primary arterial thrombectomies are coded per vascular family
• Secondary arterial thrombectomies report removal of short segments of thrombus before or after other percutaneous interventions
• Transcatheter thrombolysis is coded per day of treatment
• Reporting bilateral procedures requires a secondary access point
• Significant and separately identifiable E/M services are reportable in conjunction with transcatheter thrombolysis
• For both thrombectomy and thrombolysis, some procedures such as catheter placement and diagnostic studies are reportable in addition to the codes for the primary procedure

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Test Your Knowledge

For detailed explanations of the quiz answers, please refer to the end of this blog post.

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Quiz Answers and Rationale

Question 1: The answer is Catheter placement. Placement of catheters for the performance of thrombectomy or thrombolysis is separately reportable.

Question 2: The answer is 37184, 37185. Reporting thrombectomy in two arteries within the same vascular family is reported with 37184 for the initial vessel treated and 37185 for the second vessel treated.

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The information contained in this coding advice is valid at the time of posting. Viewers are encouraged to research subsequent official guidance in the areas associated with the topic as they can change rapidly.