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We are almost mid way through the year, and by now you should be well-versed with all the CPT changes affecting your cardiology practice this year. However, if you're not up to speed with these changes, read on and get more insight. This time CPT has added new codes for lower extremity endovascular revascularization covering angioplasty, atherectomy, and stenting. Here we take a look at femoral/popliteal codes 37224-37227. The new femoral/ popliteal service codes are angioplasty: 37224, Atherectomy (and angioplasty): 37225, Stent and atherectomy (and angioplasty): 37227. The general rule for 37224-37227 is that you should report the one code that represents the most intensive service carried out in a single lower extremity vessel. In that one code, all lesser services are covered. When the cardiologist carried out a stent placement, atherectomy, and angioplasty in the left popliteal vessel, you should use only 37227. That code covers stent placement, atherectomy, and angioplasty. You should code 37224, 37225 or 37226 separately or in addition to 37227 in this situation. Last year, you reported a superficial femoral artery angioplasty via antegrade puncture using just-deleted code 35474 and 75962. This year you need to report only 37224 to cover all of the services. If the doctor performs mechanical thrombectomy, thrombolysis or both to help restore blood flow to the occluded area, according to CPT, you may report those services separately. If the physician carries out mechanical thrombectomy, thrombolysis or both to help restore blood flow to the occluded area, you should report those services separately, says CPT. Codes 37220-+37235 apply to different territories and each territory has its own specific set of guidelines. Codes 37224-37227 fall under the femoral/popliteal vascular territory. According to CPT, the entire femoral/popliteal territory in 1 lower extremity is considered a single vessel for CPT reporting. Therefore, you should report a single code even if the cardiologist carried out various interventions for various lesions in the popliteal artery and in the common, deep, and superficial femoral arteries in the same leg at the same session. In situations such as these, you should use the code for the most complex service. If the cardiologist carries out angioplasty in the left popliteal artery and atherectomy in the left common femoral, you should report atherectomy code 37225 only. For further details on this and for other specialty-specific articles to assist your cardiology coding, sign up for medical coding resource like Coding Institute.
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