How do you code for a procedure when using an AngioVac device? Do you use the standard thrombectomy codes? Are there additional codes to account for the need for venovenous bypass and extracorporeal membrane oxygenation (EMCO)?
When new technologies, devices or procedures come to the market, the CPT/RUC team is faced with evaluating the work performed in the setting of current coding schemas. While there is significant work performed while using this device, there is the ability to report this work using current component coding methodology. The mechanical thrombectomy codes (37184–37188) cover various types of thrombectomy procedures and are not limited or defined by the use of specific devices. For this reason, it would be appropriate to report 37184 for arterial use or 37187 for venous use (in a primary/initial setting).
Additionally, one should report all appropriate catheter placement codes (selective and/or nonselective), accounting for multiple access sites if used. If diagnostic angiography is performed and medical necessity documented, this should also be reported. Needless to say, the perfusionist involved in the procedure will be reporting their own set of CPT codes to account for their work.
Disclaimer: SIR is providing this billing and coding guide for educational and information purposes only. It is not intended to provide legal, medical or any other kind of advice. The guide is meant to be an adjunct to the American Medical Association’s (AMA’s) Current Procedural Terminology (2021/CPT®). It is not comprehensive and does not replace CPT. Our intent is to assist physicians, business managers and coders. Therefore, a precise knowledge of the definitions of the CPT descriptors and the appropriate services associated with each code is mandatory for proper coding of physician service. Please refer to 2021 CPT® for full and complete guidelines.
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