June 2015 Q & A

Question: Balloon Dilatation and Stenting of Intrathoracic Innominate Artery

The doctor would like to charge 36217, 37218, 75710-26 for this procedure: 1. Right femoral artery cannulated in retrograde fashion. 2. Catheter into orgin of the innominate. 3. Then catheter passed selectively into the origin of the common carotid artery. 4. Then catheter selective out into the subclavian and selctive angiography was performed and confirmed subclavian widely patent. 5. Balloon dilatation performed and did not get good result. 6. Stent placed over ostial and proximal portion of innominate artery.


Answer:

This procedure is described by CPT code 37218. CPT code 37218 includes ipsilateral imaging and catheter placement, so it is the only code reported. Code 37218 is an inpatient-only procedure. If the subclavian artery was treated instead of the innominate artery, I would code the catheter placement (36216), the imaging (75710), and the stent placement (37236). Had they performed this procedure from the right brachial or radial access, the codes would be 36200, 75710, and 37236.