Peripheral Embolization Coding & Reimbursement Guide

2023 Peripheral Embolization Coding Guide

CPT? codes, descriptions and other data only are copyright 2022 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply. Fee schedules, relative value units, conversion factors and/or related components aren't assigned by the AMA, aren't part of CPT?, and the AMA isn't recommending their use. The AMA doesn't directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.

Therapy

Embolization

CPT?

37241 37242 37243 37244

Description

Vascular embolization or occlusion, venous, other than hemorrhage Vascular embolization or occlusion, arterial, other than hemorrhage or tumor Vascular embolization or occlusion, for tumors, organ ischemia, or infarction Vascular embolization or occlusion, for arterial or venous hemorrhage or lymphatic extravasation

Arterial Catheterization

36215 36216 36217 +36218 36245

Selective catheter placement, arterial system; 1st order thoracic or brachiocephalic branch Selective catheter placement, arterial system; 2nd order thoracic or brachiocephalic branch Selective catheter placement, arterial system; 3rd order thoracic or brachiocephalic branch ...additional 2nd or 3rd order Selective catheter placement, arterial system; 1st order abdominal, pelvic, or lower extremity artery

36246 Selective catheter placement, arterial system; 2nd order abdominal, pelvic, or lower extremity artery

36247 Selective catheter placement, arterial system; 3rd order abdominal, pelvic, or lower extremity artery

Venous Catheterization

Pulmonary Artery Catheterization Portal Vein Catheterization

+36248 36011 36012

36015

36481

...additional 2nd or 3rd order Selective catheter placement, venous system; 1st order branch (eg, renal vein, jugular vein) Selective catheter placement, venous system; 2nd order, or more selective, branch (eg, left adrenal vein, petrosal sinus) Selective catheter placement, segmental or subsegmental pulmonary artery

Percutaneous portal vein catheterization by any method

General Coding Notes

? Codes include supervision and interpretation, road-mapping and imaging required to complete the procedure. ? Code embolizations once per surgical site, regardless of the number of vessels that are occluded. ? Report selective catheter placements and diagnostic angiography separately. ? Code the main reason for performing the embolization. For example, if bleed in a tumor is the primary reason for the intervention, then

bill 37244 (vasc embolize/occlude bleed) vs 37243 (vasc embolize/occlude organ). ? These codes do not represent embolizations in the head/ neck or dialysis circuit. ? For further coding information please contact the Medtronic's Cardiovascular Health Economics, Policy & Reimbursement team.

1 | Peripheral Embolization Coding Guide US | December 2022 | UC202212476aEN

Example Diagnosis Codes

Diagnosis

Liver cancer

Varicocele Uterine fibroids Pelvic congestion syndrome

ICD-10-CM

C22.0 C22.1 C78.7 C7B.02 I86.1 D25.0 - D25.9 I86.2

ICD-10-CM Description

Liver cell carcinoma (hepatocellular carcinoma) Intrahepatic bile duct carcinoma (cholangiocarcinoma) Secondary malignant neoplasm of liver and intrahepatic bile duct Secondary carcinoid tumors of liver Scrotal varices Leiomyoma of uterus Pelvic varices

AAA Endoleak (Type II) Abdominal aortic aneurysm

I97.89 I71.40 -- I71.43

Other postprocedural complications and disorders of the circulatory system, not elsewhere classified

Abdominal aortic aneurysm, without rupture

Arteriovenous malformation, pulmonary Arteriovenous malformation, uterine

Arteriovenous malformation, renal Aneurysm, peripheral

Q25.72

Q27.39 I77.0 Q27.34

I72.2 I72.3 I72.8

Congenital pulmonary arteriovenous malformation

Arteriovenous malformation, other site (congenital) Arteriovenous fistula, acquired Arteriovenous malformation of renal vessel (congenital)

Aneurysm of renal artery Aneurysm of iliac artery Aneurysm of other specified arteries (e.g., SMA, splenic, celiac, hepatic)

Note: These diagnosis codes do not include those associated with traumatic injury.

There are no recommended HCPCS codes for Medtronic's Embolization products

According to CMS, providers should report their charges under the revenue code that will result in the charges being assigned to the same cost center to which the cost of those services are assigned in the cost report

CPT? codes, descriptions and other data only are copyright 2022 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply. Fee schedules, relative value units, conversion factors and/or related components aren't assigned by the AMA, aren't part of CPT?, and the AMA isn't recommending their use. The AMA doesn't directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.

Code descriptions have been abbreviated in this document. For specific AMA descriptions of current CPT? coding, please refer to the most recent version of the CPT? Coding Book.

Medtronic does not represent or guarantee that this information is complete, accurate, or applicable to any particular patient or third party payer. Medtronic disclaims all liability for any consequence resulting from reliance on this document. The final decision of billing for any service must be made by the health care provider considering the medical necessity of the service furnished as well as the requirements of third-party payers and any local, state, or federal laws and regulations that apply. Medtronic is providing this information in an educational capacity with the understanding that Medtronic is not engaged in rendering accounting, or other professional services. Medtronic encourages all health care providers to consult with their own advisors regarding coding and payment. Medtronic doesn't offer products with approved indications for all procedures listed. For more information, contact the Cardiovascular Health Economics, Policy & Reimbursement Team.

UC202212476aEN ?2022 Medtronic. Medtronic, Medtronic logo, and Engineering the extraordinary are trademarks of Medtronic. All other brands are trademarks of a Medtronic company. 12/2022

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