CPT 2014 – Stent Placement

Vascular StentingThere are several new and revised CPT codes that will affect cardiologists and vascular surgeons in 2014.  In particular, we will see changes in how we code stenting in certain vessels.  CPT codes 37205-37208 have been deleted.

The RUC Relativity Assessment Workgroup continues their mission of abandoning the component coding concept and bundling certain services into single codes based on their 75 percent rule.  For code pairs that are billed together greater than 75 percent of the time, new CPT codes are created are created bundling multiple procedures into one code.

The new CPT codes for stent procedures apply to any artery that does not already have an anatomy-specific CPT code (ie, lower extremity, cervical carotid, extracranial vertebral or intrathoracic carotid, intracranial, or coronary).  New codes for venous stenting have also been created.  These new codes bundle the surgical and radiologic portions into a single code.  In addition, any ballooning performed to treat the stented vessel is included and should not be reported separately.  You should refer to the introduction of this new section of the CPT book for specific reporting guidelines.

Unlike the lower extremity revascularization codes, the catheter placement should be reported separately.  In addition, you can bill separately for extensive artery repair, ultrasound guidance for vascular access, thrombolysis, thrombectomy, and intravascular ultrasound.  Code selection is based on each vessel treated and on the type of vessel treated.

37236 – Transcatheter placement of an intravascular stent(s) (except lower extremity, cervical carotid, extracranial vertebral or intrathoracic carotid, intracranial, or coronary), open or percutaneous, including radiological supervision and interpretation and including all angioplasty within the same vessel, when performed; initial artery

37237 – each additional artery

37238 – Transcatheter placement of an intravascular stent(s), open or percutaneous, including radiological supervision and interpretation and including all angioplasty within the same vessel, when performed; initial vein

37239 – each additional vein

For Dialysis AV Fistulas and Grafts, the shunt is divided into two vessel segments, peripheral and central.  Treatment in the peripheral segment should be coded using one venous code for all vessels in that segment.  Treatment of the anastomotic region will be coded using the arterial code and includes the venous peripheral segment.  If a lesion in the central segment is also treated, an additional stenting code may be reported.

 

 

 

 

 

 

 

 

 

CPT codes and their descriptors are copyright 2013 by the American Medical Association.