CPT® 2017: 5 Fast Facts to Master New Angioplasty Codes

CPT 2017 transluminal balloon angioplasty coding

Veteran vascular coders have watched CPT® change their coding options year after year from component codes (separating out each element of a procedure) into more comprehensive codes. One of the targets in CPT® 2017 is transluminal balloon angioplasty. Get up to speed on proper use of these new codes with these quick tips.

1. Keep Artery and Vein Options Separate

The first two new angioplasty codes represent artery services (bold added):

  • 37246, Transluminal balloon angioplasty (except lower extremity artery[ies] for occlusive disease, intracranial, coronary, pulmonary, or dialysis circuit), open or percutaneous, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty within the same artery; initial artery
  • +37247, … each additional artery (List separately in addition to code for primary procedure).

You’ll have two other new codes that apply to vein services (bold added):

  • 37248, Transluminal balloon angioplasty (except dialysis circuit), open or percutaneous, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty within the same vein; initial vein
  • +37249, … each additional vein (List separately in addition to code for primary procedure).

2. Don’t Report Related S&I Separately

The code descriptors state that the codes include “all imaging and radiological supervision and interpretation necessary to perform the angioplasty within the same” vessel.

That means that instead of the component code approach of reporting one code for the angioplasty and another code for the radiological supervision and interpretation (S&I), the new codes take a more comprehensive approach, bundling both aspects into the same code.

3. Apply Same Codes to Open and Percutaneous

These new codes, 37246 to +37249, apply regardless of whether the procedure is open or percutaneous. This update is in line with other changes CPT® has made to vascular codes in recent years, such as endovascular revascularization codes 37220 to 37239. Those codes also apply to both open (larger incision with visualization) or percutaneous (minimally invasive through the skin).

4. Remember Add-On for Each Additional Vessel

When you reviewed the descriptors for the new codes, did you catch that you have different options for initial and additional vessels?

Apply 37246 to the initial artery and then add +37247 for each additional artery treated in the same session.

The vein codes follow a similar structure with 37248 for the initial vein and +37249 for each additional vein.

5. Look Elsewhere to Code Exceptions

One of the trickier aspects of the new codes is that the descriptors tell you only which vessels the codes do NOT apply, not which vessels the new codes do apply to.

In both the artery and vein code descriptors you’ll see that the codes are not appropriate for angioplasty in the dialysis circuit, which CPT® 2017 adds some other new codes for.

The artery descriptors also exclude services on the lower extremity arteries for occlusive disease and intracranial, coronary, and pulmonary artery services.

Bottom line: Use your CPT® Index and read the coding guidelines to be sure you’ve chosen the appropriate code for the patient’s case.

What About You?

Are you new to coding angioplasty or have you been rolling with the changes through the years? Do you prefer component codes or a more all-in-one approach?

About 

Deborah concentrates on coding and compliance for radiology and cardiology, including the tricky world of interventional procedures, as well as oncology and hematology. Since joining The Coding Institute in 2004, she’s also covered the ins and outs of coding for orthopedics, audiology, skilled nursing facilities (SNFs), and more.

, ,

3 Comments For This Post

  1. Kathy Smith Says:

    I AM JUST NOT SURE WHAT VEINS OR ARTERIES THESE CODES ARE USED ON
    I CURRENTLY CODE FOR LOWER EXTREMITY AND CORONARY INTERVENTION
    MAYBE MY BRAIN IS FRIED TODAY AND I CAN’T ABSORB WHAT THE CPT BOOK IS SAYING
    HOPE YOU CAN CLARIFY WHEN I WHERE I SHOULD BE USING THESE CODES

    THANK YOU
    KATHY

  2. Deborah Marsh Says:

    Hi, Kathy – Good question! The descriptor wording does make it tough to be sure which vessels the codes apply to. In the AMA Index Angioplasty entry, examples of where you’ll find the codes listed include Aorta, Axillary, Brachiocephalic, Renal, Subclavian, and Visceral. But reading the guidelines with the codes will definitely be important to be sure the code is reportable, especially if the angioplasty is part of a larger procedure. I hope that helps!

  3. Jamie Says:

    I have seen that 37246 is no longer to be reported with 37236. Our physician performs balloon angioplasty and stenting in he aorta as well as the renals frequently. I don’t see another code I should use for the stenting portion of the procedure. Please advise.
    Thank you,
    Jamie

Leave a Reply