CPT 2011: Femoral/Popliteal Coding Options

Published: 18th March 2011
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This time CPT 2011 adds new codes for lower extremity endovascular revascularization covering angioplasty, atherectomy, and stenting.



Here we'll take a look at the femoral/popliteal codes 37224-37227.



Master the single code approach for fem/pop coding



Remember that all of the codes include angioplasty in the same vessel when that service is carried out:



  • Angioplasty: 37224 -- Revascularization, endovascular, open or percutaneous, femoral/popliteal artery(s), unilateral; with transluminal angioplasty

  • Atherectomy (and angioplasty): 37225 -- with atherectomy, covers angioplasty within the same vessel, when carried out

  • Stent (& angioplasty): 37226 -- with transluminal stent placement(s), covers angioplasty within the same vessel, when carried out

  • Stent & atherectomy (and angioplasty): 37227 -- with transluminal stent placement(s) and atherectomy, includes angioplasty within the same vessel, when carried out.



    Note: Usually, the 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.



    Example: When the radiologist carries out a stent placement, atherectomy, and angioplasty in the left popliteal vessel, you should report 37227 only. That code includes stent placement, atherectomy, and angioplasty. In this scenario, you shouldn't report 37224 (angioplasty), 37225 (atherectomy), or 37226 (stent placement) separately or in addition to 37227.



    Take a look at the change from component coding



    According to CPT guidelines, in addition to the intervention carried out, the codes include:



  • Accessing the vessel

  • Selectively catheterizing the vessel

  • Crossing the lesion

  • Radiological supervision and interpretation for the intervention carried out

  • Any embolic protection used

  • Closure of arteriotomy (incision in the artery)

  • Imaging carried out to document the intervention was completed.



    To avoid denials, apply this territory rule



    The just-in codes 37220-+37235 apply to different territories. Every territory has its own specific set of guidelines. Codes 37224-37227 come under the femoral/popliteal vascular territory.



    Important rule: According to CPT, the entire femoral/popliteal territory in 1 lower extremity is considered a single vessel for CPT reporting.



    Consequently, you should report a single code even if the radiologist 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.



    For more on this, sign up for a medical coding guide like Supercoder.




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