Arterial Map of the Thorax, Abdomen and Pelvis 2017 Edition

Transcription

1 Arterial Map of the Thorax, Abdomen and Pelvis Angiography (-26) Aortography, thoracic (-26) Aortography, abdominal by serialography (-26) Aortography, abdominal + bilat iliofemoral (-26) Spinal, selective (-26) Visceral, selective (w/ flush aortogram) (-26) Pelvic, selective (-26) Selective, each additional vessel Renal Arteriogram* Selective Superselective Unilateral Bilateral *Includes catheterization and imaging. Runoff Study single catheter placement multiple catheter placement (abdominal aorta and at or just above bifurcation) Pelvis selective and unilateral; if bilateral pelvic vessels are selectively catheterized and studied, use A nonselective pelvic study is assigned code or 75716, depending on the physician dictation of vessels studied. All rights reserved. No part of this job aid may be reproduced in any form whatsoever without written permission from the publisher. This job aid reflects coding information from the 2017 Physicians Current Procedural Terminology CPT manual. This is not to be used in place of the CPT manual. CPT is a registered trademark of the American Medical Association. CPT five digit codes, nomenclature and other data are Copyright 2016 AMA.. No fee schedules, basic units, relative values or related listings are included in CPT. AMA does not directly or indirectly practice medicine or dispense medical services. AMA assumes no liability for the data contained herein or not contained herein. More resources available at

2 Selective Arterial Codes Angiography Aortography, abdominal Aortography, abdominal + bilat iliofemoral Brachial, retrograde Extremities, unilateral Extremities, bilateral Visceral, selective or suprasel (w/ flush) Pelvic, selective or supraselective Selective, each additional vessel

3 Venous and Portal Systems Internal Jugular Vein () Rt External Jugular Vein () Lt External Jugular Vein () Rt Subclavian Vein () Lt Subclavian Vein () Rt Brachiocephalic Vein (36011) Lt Brachiocephalic Vein (36011) Middle Hepatic Vein (36011) Rt Hepatic Vein (36011) Rt Adrenal Vein (36011) Lt Hepatic Vein (36011) Lt Adrenal Vein () Imaging Jugular Hepatic w/pressures w/o Pressures Adrenals /75842 Renals /75833 Extremities /75822 Rt Renal Vein (36011) Lt Renal Vein (36011) Rt Renal Vein Branches () Lt Renal Vein Branches () Rt Gonadal Vein (36011) Lt Gonadal Vein () Rt Common Iliac Vein (36005) Lt Common Iliac Vein (36011) Rt External Iliac Vein (36005) Lt External Iliac Vein () Rt Internal Iliac Vein (36011) Lt Internal Iliac Vein () Selective Catheter Placement st order 2 nd order or more selective branch Non-Selective Catheter Placement Superior or inferior vena cava Injection for extremity venography Note: No 3 rd order exists, assign as needed S&I Codes Extremity, unilateral Extremity, bilateral Caval, inferior Caval, superior Renal, unilateral, selective Renal, bilateral, selective Adrenal, unilateral, selective Adrenal, bilateral, selective Sinus or jugular, catheter Superior sagittal sinus Epidural Orbital Portography with hemodynamic evaluation Portography without hemodynamic evaluation Hepatic venography, with hemodynamic evaluation Hepatic venography, without hemodynamic evaluation TIPS insertion TIPS revision

4 Venous System Inferior Vena Cava Rt Common Iliac Lt Internal Iliac Lt Common Iliac Lt External Iliac Lt Common Femoral Lt Profunda Femoral Great Saphenous Femoral Popliteal Small Saphenous Anterior Tibial Superior Sagittal Sinus (75870) Superficial Temporal Vein Angular Vein Posterior Tibial Occipital Vein Sinus or jugular (75860) External Jugular Vein Facial Vein Right Subclavian Vein Anterior Jugular Vein Interior Jugular Vein Right Innominate Vein Superior Vena Cava Central Venous Catheters Centrally Inserted Peripherally Inserted Non- Tunneled no port/pump Tunneled w/o port/pump w/port w/ pump (PICC) w/port Insertion (<5 yrs) n/a Insertion (>5 yrs) (1 access) (1 access) (2 accesses) (2 accesses) Repair n/a Replacement (cath only) n/a n/a n/a Replacement (complete) Through same access Removal Guidance Fluoroscopic guidance Ultrasound guidance Device/Catheter Declot Declotting by thrombolytic agent Repositioning 36597/76000 Repositioning of previously placed central venous catheter Contrast Injection Only Contrast injection(s) for radiologic evaluation of existing CV access device 36596/75902 Mechanical removal of obstructive material through device lumen Catheter Stripping 36595/75901 Mechanical removal of obstructive material separate venous access

5 Transcatheter Procedures ILIAC REVASCULARIZATION Each Add l Vessel Initial Vessel Common iliac, internal iliac, external iliac (Max 2) Angioplasty only Stent placement (with or without angioplasty) FEMORAL/POPLITEAL REVASCULARIZATION One vessel Code Angioplasty only Atherectomy (with or without angioplasty) Stent placement (with or without angioplasty) Stent placement and Atherectomy (with or without angioplasty) TIBIAL/PERONEAL REVASCULARIZATION Each Add l Vessel Initial Vessel Anterior tibial, posterior tibial, peroneal (Max 2) Angioplasty only Atherectomy (with or without angioplasty) Stent placement (with or without angioplasty) Stent placement and Atherectomy (with or without angioplasty) Revascularization codes include catheterization and S&I to accomplish the procedure. Code diagnostic angiograms separately (S&I only) if they meet CPT guidelines. Assign only one revascularization code per vessel. Code left and right extremities separately. Angioplasty (Do not use for lower extremity occlusive disease) (Includes S&I) Initial artery Each additional artery Initial vein Each additional vein Stent Placement (Do not use for lower extremity occlusive disease) (Includes angioplasty and S&I) Initial artery Each additional artery Initial vein Each additional vein Cervical carotid artery stent placement with embolic protection Without embolic protection Antegrade common carotid or innominate stent placement 0075T Extracranial vertebral artery, initial vessel +0076T Each additional vessel Mechanical Thrombectomy Primary arterial mechanical thrombectomy, initial vessel Additional vessel(s) within same vascular family Secondary arterial mechanical thrombectomy Venous mechanical thrombectomy Repeat venous thrombectomy on subsequent day during thrombolysis

6 Transcatheter Procedures Embolization Report embolization once per surgical field Venous, other than hemorrhage (includes RS&I) Arterial, other than hemorrhage or tumor (includes RS&I) For tumor, organ ischemia, or infarction (includes RS&I) For arterial or venous hemorrhage or lymphatic extravasation (includes RS&I) Central nervous system (intracranial, spinal cord) Head and neck, non-central nervous system (extracranial, brachiocephalic) Transcatheter embolization S&I (Use only with and 61626) Follow-up angiography (Use only with and 61626) Transcatheter Thrombolytic Infusion Report infusion once per operative field Transcatheter thrombolysis, day #1, arterial Transcatheter thrombolysis, day #1, venous Transcatheter thrombolysis, subsequent day Transcatheter thrombolysis, final day Intracranial Procedures Balloon angioplasty (e.g., stenosis) Stent placement (e.g., stenosis) (includes angioplasty) Balloon dilation of vasospasm, initial vessel Each additional vessel in same vascular family Each additional vessel in different vascular family Arterial mechanical thrombectomy and/or thrombolytic infusion Prolonged administration of non-thrombolytic agents, initial territory Additional territory Filters and Foreign Bodies Percutaneous vena cava filter placement Vena cava filter repositioning Vena cava filter retrieval Transcatheter retrieval of intravascular foreign body Dialysis Circuit (Fistula/Graft) Catheterization with fistulogram Balloon angioplasty in peripheral segment (includes 36901) Stent placement in peripheral segment (includes 36901) (includes peripheral angioplasty) Mechanical thrombectomy, peripheral and/or central (includes 36901) With peripheral segment angioplasty With peripheral segment stent placement Angioplasty of central segment (report with ) Stent placement in central segment (includes central angioplasty) (report with ) Embolization of collateral(s) or main circuit (report with ) Code no more than one PTA or stent placement in each segment.

7 Nonvascular Procedures Following is a list of commonly performed nonvascular procedures. It is not intended to be a complete listing of all possible codes that may be needed for a given case. Biliary Procedures Existing Access New Access Percutaneous transhepatic cholangiogram (PTC) Place external biliary drainage catheter n/a Place internal-external biliary drainage catheter n/a Place biliary stent or Convert external to internal-external drainage catheter n/a Change biliary drainage catheter n/a Remove drainage catheter under fluoro n/a Dilate bile duct NOTICE The contents of this Job Performance Aid (JPA) are copyrighted 2016 by Coding Strategies, Inc., Powder Springs, Georgia. It is illegal to reproduce in any form any part of this JPA without written permission from the publisher. When a third party payor is involved, the determination of reimbursement for services is the payor s decision based on the patient s policy and the payor s guidelines. No manual can adequately address reimbursement issues for all payors, so it is essential to contact each payor for their individual requirements. This JPA should not be considered a substitute for the codes, cross-references and exclusions located in the CPT manual.