February 2017 Q & A

Question: C2623 vs 37220

We have been getting edits when codes C2623 (Catheter, transluminal angioplasty, drug-coated, non-laser) and 37220 (Revascularization, endovascular, open or percutaneous, iliac artery, unilateral, initial vessel; with transluminal angioplasty) are on the same claim, but I can find nothing to indicate that this code pair should create an edit. Edit reads: when C2623 is on the claim then 37224 or 37226 must also be on the claim?

Answer:

Drug coated balloons were originally only approved for knee and thigh revascularization. We cannot find where that has changed. The last information we have seen from CMS on the topic is the April 2016 updates to the Outpatient Code Editor, and the only codes that they link with C2623 (for device offset) are 37224, 37225, 37226, 37227. We don’t think these drug coated angioplasty catheters are approved for use in the iliac artery as of the date of this response.