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Remember the 'single vessel' exception. Ensure your surgery practice is prepared to implement the makeover of endovascular revascularization coding. CPT 2011 has new codes intended for lower extremity endovascular revascularization, including angioplasty, atherectomy, and stenting. Read on for general surgery billing and coding expert information and learn the details of femoral/popliteal codes 37224-37227. Single Code Approach for Fem/Pop Coding Familiarize yourself with the following listed new femoral/popliteal service codes, and remember that all of the codes cover angioplasty in the similar vessel when that particular service is performed: Angioplasty: 37224 -- Revascularization, endovascular, either open or percutaneous, femoral/popliteal artery(s), unilateral; including transluminal angioplasty Atherectomy (plus angioplasty): 37225 -- including atherectomy, includes angioplasty in the same vessel, when performed Stent (plus angioplasty): 37226 -- including transluminal stent placement(s), with angioplasty executed within the same vessel, when performed Stent and atherectomy (and angioplasty): 37227 -- including transluminal stent placement(s) as well as atherectomy, with angioplasty executed within the same vessel, when performed. Remember: The universal rule for 37224-37227, you should follow, is that you should report the one particular code that denotes the most intensive service performed in a single lower extremity vessel. All lesser services are inlcuded in that one particular code. For instance: While your surgeon carries out a stent placement, atherectomy, as well as angioplasty in the left popliteal vessel, you should always simply report 37227. That code includes stent placement, atherectomy, as well as angioplasty. You should not, though, report 37224 (angioplasty), 37225 (atherectomy), or 37226 (stent placement) distinctly or along with 37227 in this scenario. Avoid Denials With This Territory Rule The new revascularization codes (37220-+37235) apply to dissimilar "territories." Every territory takes its own definite set of rules. Codes 37224-37227 come under the femoral/popliteal vascular territory. Key rule: CPT maintains that the whole femoral/popliteal territory in 1 lower extremity is considered as a single vessel for CPT reporting. Accordingly, you should report a single code although the surgeon performed several interventions for different lesions in the popliteal artery and within the common, deep, and superficial femoral arteries in the similar leg and at the same session. In these circumstances, you should always use the code for the furthermost complex service. For instance: In case the surgeon carries out angioplasty in the left popliteal artery and atherectomy within the left common femoral, you are supposed to report only atherectomy code 37225. Remember: These codes are unilateral, which simply denotes that they apply to a service on a single side of the body. CPT specifies that in case the physician treats the identical territory (such as femoral/popliteal) in both legs at the similar session, you should always use modifier 59 (Distinct procedural service) to establish that both legs are involved. Want to know get more expert general surgery billing and coding tips like these? Click here to read the entire article and to get access to our monthly General Surgery Coding Alert: Your practical adviser for ethically optimizing general surgery billing and coding, payment, and efficiency for general surgery practices Read more to perfect your general surgery billing and coding: http://www.supercoder.com/articles/articles-alerts/gca/cpt-2011-37224-37227-capture-pay-for-femoralpopliteal-revascularization/
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