April 2015 Q & A

Question: Pre-Procedure SIRTeX GDA Embolization with Angiograms

We routinely perform pre-procedure embolization and roadmapping prior to the SIRTeX procedure. When the GDA is embolized we are using CPT code 37242 for the embolization. Can we bill the pre-procedure roadmapping for the SIRTeX at the same time as the GDA embolization? From report: IMPRESSION: Arterial mapping and coil embolization as described above for preprocedure SIRTeX SIR-Spheres selective internal radiation therapy (SIRT).


Answer:

Yes. 37242 is the code for non-target vessel embolization done at a session separate from the Y-90 embolization procedure. The imaging, if diagnostic, is separately billable as well. If imaging and GDA coiling is done at the same session as the SIRT, the imaging is usually for guidance and is not billable, and the embolization is bundled into code 37243 for the Y-90 embolization. You do NOT code 37242 at the same session. Only one embolization code per surgical site per session.