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Peripheral Intervention Codes

Providers should consult with their payers regarding appropriate documentation, medical necessity and coding information consistent with individual payer requirements and policies.  

ICD-10-CM diagnosis codes and ICD-10-PCS procedure codes are effective as of October 1, 2015. If you have any questions related to the former ICD-9 or current ICD-10 coding for procedures involving Abbott Vascular devices, please contact the Reimbursement Hotline at 800 354 9997 or Questions@AskAbbottVascular.com.

In addition to the codes provided below, diagnostic angiography, catheter placement, or radiological supervision and interpretation codes may apply.

 

ICD-10-PCS Procedure Codes

ICD-10-PCS tables below are excerpted from the ICD-10-PCS Code Set. Please refer to the official ICD-10-PCS Code Set for complete tables.

ICD-10-PCS Procedure Codes
0      Medical and Surgical
4      Lower Arteries
7      Dilation – Expanding an orifice or the lumen of a tubular body part
Body Part Character 4 Approach Character 5 Device Character 6 Qualifier Character 7

9 Renal Artery, Right
A Renal Artery, Left
C Common Iliac Artery, Right
D Common Iliac Artery, Left
E Internal Iliac Artery, Right
F Internal Iliac Artery, Left
H External Iliac Artery, Right
J External Iliac Artery, Left
K Femoral Artery, Right
L Femoral Artery, Left
M Popliteal Artery, Right
N Popliteal Artery, Left
P Anterior Tibial Artery, Right
Q Anterior Tibial Artery, Left
R Posterior Tibial Artery, Right
S Posterior Tibial Artery, Left
T Peroneal Artery, Right
U Peroneal Artery, Left
Y
Lower Artery

3 Percutaneous D Intraluminal Device
Z No Device
Z No Qualifier

 

ICD-10-PCS Procedure Codes
0      Medical and Surgical
3      Upper Arteries
7      Dilation – Expanding an orifice or the lumen of a tubular body part
Body Part Character 4 Approach Character 5 Device Character 6 Qualifier Character 7
5 Axillary Artery, Right
6
Axillary Artery, Left
7
Brachial Artery, Right
8
Brachial Artery, Left
9
Ulnar Artery, Right
A
Ulnar Artery, Left
B
Radial Artery, Right
C
Radial Artery, Left
Y
Upper Artery
3 Percutaneous Z No Device Z No Qualifier

 

Peripheral Angioplasty

CPT® Codes
35471

Transluminal balloon angioplasty, percutaneous; Renal or visceral artery

35475

Transluminal balloon angioplasty, percutaneous; Brachiocephalic trunk or branches, each vessel

35476 Transluminal balloon angioplasty, percutaneous; Venous
37220 Revascularization, endovascular, open or percutaneous, iliac artery, unilateral, initial vessel; with transluminal angioplasty
37222 Revascularization, endovascular, open or percutaneous, iliac artery, each additional ipsilateral iliac vessel; with transluminal angioplasty (List separately in addition to code for primary procedure)
37224 Revascularization, endovascular, open or percutaneous, femoral/popliteal artery(s), unilateral; with transluminal angioplasty
37228 Revascularization, endovascular, open or percutaneous, tibial/peroneal artery, unilateral, initial vessel; with transluminal angioplasty
37232 Revascularization, endovascular, open or percutaneous, tibial/peroneal artery, unilateral, each additional vessel; with transluminal angioplasty (List separately in addition to code for primary procedure)

 

Peripheral Stent Placement

CPT® Codes
37221

Revascularization, endovascular, open or percutaneous, iliac artery, unilateral, initial vessel; with transluminal stent placement(s), includes angioplasty within same vessel, when performed

37223 Revascularization, endovascular, open or percutaneous, iliac artery, each additional ipsilateral iliac vessel; with transluminal stent placement(s), includes angioplasty within same vessel, when performed (List separately in addition to code for primary procedure)
37226 Revascularization, endovascular, open or percutaneous, femoral/popliteal artery(s), unilateral; with transluminal stent placement(s), includes angioplasty within the same vessel, when performed
37230 Revascularization, endovascular, open or percutaneous, tibial/peroneal artery, unilateral, initial vessel; with transluminal stent placement(s), includes angioplasty within the same vessel, when performed
37234

Revascularization, endovascular, open or percutaneous, tibial/peroneal artery, unilateral, each additional vessel; with transluminal stent placement(s), includes angioplasty within the same vessel, when performed (List separately in addition to code for primary procedure)

37236  Transcatheter placement of an intravascular stent(s) (except lower extremity artery(s) for occlusive disease, cervical carotid, extracranial vertebral or intrathoracic carotid, intracranial, or coronary), open or percutaneous, including radiological supervision and interpretation and including all angiooplasty within the same vessel, when performed; initial artery 
37237  Transcatheter placement of an intravascular stent(s) (except lower extremity artery(s) for occlusive disease, cervical carotid, extracranial vertebral or intrathoracic carotid, intracranial, or coronary), open or percutaneous, including radiological supervision and interpretation and including all angioplasty within the same vessel, when performed; each additional artery (List separately in addition to code for primary procedure)
37238  Transcatheter placement of an intravascular stent(s), open or percutaneous, including radiological supervision and interpretation and including angioplasty within the same vessel, when performed; initial vein 
37239  Transcatheter placement of an intravascular stent(s), open or percutaneous, including radiological supervision and interpretation and including angioplasty within the same vessel, when performed; each additional vein (List separately in addition to code for primary procedure) 

 

Vessel Closure

The following code has been assigned to occlusive devices by CMS: G0269

G0269 is defined as: placement of an occlusive device in either a venous or arterial access site, post-surgical or interventional procedure. Code G0269 should be used on Medicare claims to record the placement of the vasoseal and for other payers as directed.

 

References:

Centers for Medicare and Medicaid Services at www.cms.gov
ICD-10 Procedure Coding System (ICD-10-PCS) 2016 Tables and Index, downloaded from http://www.cms.gov/Medicare/Coding/ICD10/2016-ICD-10-PCS-and-GEMs.html on 6/30/2015.
CPT® Copyright 2014 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association.

 

Questions about reimbursement for Abbott Vascular Products?

Contact the Reimbursement Hotline: 800 354 9997 Questions@AskAbbottVascular.com.

 

Last Updated: November 2015

Disclaimer: The information provided in this document was obtained from third-party sources and is subject to change without notice as a result of changes in reimbursement laws, regulations, rules, policies, and payment amounts. All content is informational only, general in nature, and does not cover all situations or all payers’ rules and policies. It is the responsibility of the hospital or physician to determine appropriate coding for a particular patient and/or procedure. Any claim should be coded appropriately and supported with adequate documentation in the medical record. A determination of medical necessity is a prerequisite that Abbott Vascular assumes will have been made prior to assigning codes or requesting payments. Any codes provided are examples of codes that specify some procedures or which are otherwise supported by prevailing coding practices. They are not necessarily correct coding for any specific procedure using Abbott Vascular’s products.

Hospitals and physicians should consult with appropriate payers, including Medicare Administrative Contractors, for specific information on proper coding, billing, and payment levels for healthcare procedures. Abbott Vascular makes no express or implied warranty or guarantee that (i) the list of codes and narratives in this document is complete or error-free, (ii) the use of this information will prevent difference of opinions or disputes with payers, (iii) these codes will be covered [or (iv) the provider will receive the reimbursement amounts set forth herein]. Reimbursement policies can vary considerably from one region to another and may change over time.

The FDA-approved/cleared labeling for all products may not be consistent with all uses described herein. This web page is in no way intended to promote the off-label use of medical devices. The content is not intended to instruct hospitals and/or physicians on how to use medical devices or bill for healthcare procedures.
 

 

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