Get Up to Date With a 2017 Quick Guide to EVAT Coding

CPT 2017 endovenous ablation codes

All you coders who report percutaneous endovenous ablation therapy (EVAT) can expect some interesting code changes in CPT® 2017.

Meet the New Mechanochemical Option

The big news is two new codes for mechanochemical ablation:

  • 36473, Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, mechanochemical; first vein treated
  • +36474, … subsequent vein(s) treated in a single extremity, each through separate access sites (List separately in addition to code for primary procedure).

These new codes follow the same format as existing codes 36475 and +36476 for radiofrequency ablation and 36478 and +36479 for laser ablation. The codes are for percutaneous services and include all imaging guidance and monitoring.

Adjust Add-On Descriptors

Eagle-eyed veterans may have noticed that the wording for +36474 varies a tiny bit from the 2016 descriptors for +36476 and +36479.

In 2016, the add-on codes end this way: … second and subsequent veins treated in a single extremity, each through separate access sites (List separately in addition to code for primary procedure).

In 2017, +36476 and +36479 get a descriptor tune-up so they will end the same way +36474 does: … subsequent vein(s) treated in a single extremity, each through separate access sites (List separately in addition to code for primary procedure).

The codes apply to one or more additional veins (after the first) treated through a distinct access site.

Anticipate CCI Edits

Take time to check Correct Coding Initiative (CCI) edits before reporting these codes. CCI version 22.2 added some edits involving EVAT codes. The edits prevent you from reporting the add-on code for one modality with the codes for a different modality.

Example: CCI bundles +36479 for laser ablation of subsequent veins into 36475, the code for radiofrequency ablation of a first vein. The edit has a modifier indicator of 0, so you can’t override the edit with a modifier.

When the next version of CCI comes out for the Jan. 1, 2017, implementation, it’s possible we’ll see similar edits for the new mechanochemical ablation codes, preventing you from reporting different modalities together.

Dig Deeper by Reviewing LCD

Payers have detailed rules about EVAT coverage, so be sure to review your local payer policy and watch for updates incorporating the new codes.

Typical policies require documentation that conservative therapies, like wearing compression stockings, did not work for the patient.

What About You?

Do you code EVAT services? Are you excited about your new code options, or are there other updates you’re looking forward to using?

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.

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