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Coding Tips for New CPT code 36902, 36903, 36904, 36905 and 36906

A new set of CPT codes for angioplasty, stent and thrombectomy has been added in 2017. The new codes includes the diagnostic angiography and RS&I like other existing angioplasty procedure codes. We have many new codes as already discussed previously about CPT code 36901 and the new epidural steroid injection procedure codes. If you want to be perfect in coding interventional surgery coding, do remain update with the new CPT codes. Having a good knowledge of a ICD 10 and CPT codes, will make you prepare for CPC and Certified coding specialist (CCS) exam in future. Today we will new about new CPT code 36902, 36903, 36904, 36905, 36906 and the add-on CPT code +36907, +36908, +36909. So, let us check more about these CPT codes in details.

New CPT code 36902, 36903, 36904, 36905 and 36906

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Description of new CPT codes of 2017

These new CPT codes includes few add-on codes as well. Hence, it is very important to know which are the procedure codes should be used a primary or initial codes followed by the add-on cpt codes. So, here the CPT code 36902, 36903, 36904, 36905, 36906 are used as initial or primary procedure code and CPT code +36907, +36908, +36909 are the add-on codes used along with primary procedure codes. Below are the code description of these CPT codes.

36902 – Introduction of needle(s) and/or catheter(s), dialysis circuit, with diagnostic angiography of the dialysis circuit, including all direct puncture(s) and catheter placement(s), injection(s) of contrast, all necessary imaging from the arterial anastomosis and adjacent artery through entire venous outflow including the inferior or superior vena cava, fluoroscopic guidance, radiological supervision and interpretation and image documentation and report; with transluminal balloon angioplasty, peripheral dialysis segment, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty

36903 -Introduction of needle(s) and/or catheter(s), dialysis circuit, with diagnostic angiography of the dialysis circuit, including all direct puncture(s) and catheter placement(s), injection(s) of contrast, all necessary imaging from the arterial anastomosis and adjacent artery through entire venous outflow including the inferior or superior vena cava, fluoroscopic guidance, radiological supervision and interpretation and image documentation and report; with transcatheter placement of intravascular stent(s), peripheral dialysis segment, including all imaging and radiological supervision and interpretation necessary to perform the stenting, and all angioplasty within the peripheral dialysis segment

36904 – Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis, dialysis circuit, any method, including all imaging and radiological supervision and interpretation, diagnostic angiography, fluoroscopic guidance, catheter placement(s), and intraprocedural pharmacological thrombolytic injection(s)

36905 -Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis, dialysis circuit, any method, including all imaging and radiological supervision and interpretation, diagnostic angiography, fluoroscopic guidance, catheter placement(s), and intraprocedural pharmacological thrombolytic injection(s); with transluminal balloon angioplasty, peripheral dialysis segment, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty

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36906 – Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis, dialysis circuit, any method, including all imaging and radiological supervision and interpretation, diagnostic angiography, fluoroscopic guidance, catheter placement(s), and intraprocedural pharmacological thrombolytic injection(s); with transcatheter placement of intravascular stent(s), peripheral dialysis segment, including all imaging and radiological supervision and interpretation necessary to perform the stenting, and all angioplasty within the peripheral dialysis circuit

+36907 -Transluminal balloon angioplasty, central dialysis segment, performed through dialysis circuit, including all imaging and radiological supervision and interpretation required to perform the angioplasty (List separately in addition to code for primary procedure)

+36908 – Transcatheter placement of intravascular stent(s), central dialysis segment, performed through dialysis circuit, including all imaging radiological supervision and interpretation required to perform the stenting, and all angioplasty in the central dialysis segment (List separately in addition to code for primary procedure)

+36909 – Dialysis circuit permanent vascular embolization or occlusion (including main circuit or any accessory veins), endovascular, including all imaging and radiological supervision and interpretation necessary to complete the intervention (List separately in addition to code for primary procedure)

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When to use CPT code 36902 and 36903

CPT code 36902 are used mainly for the diagnostic angiography exam of blood vessels of dialysis circuit. The dialysis circuit involves the blood vessels used for filtration of waste materials from the blood in patients with kidney failure. This code includes the angioplasty, radiological supervision and interpretation (RS&I) and should not be used more than once per operative session. CPT code 36903 has similar code description like code 36902, but is used for coding intravascular stent placement in dialysis circuit. Do not report CPT code 36902 along with 36903.

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When to use CPT code 36904 and 36905

CPT code 36904 is used for coding thrombolysis in the dialysis circuit. You can use this cpt code for coding thrombolysis and/or thrombectomy in dialysis circuit. It includes all the minor procedures from inserting the catheter to the removal of blood clot from the dialysis circuit. This code includes all the angiography procedures the RS&I performed during this exam.  CPT code 36905 is almost similar to code 36904 with the exception of angioplasty exam. Code 36905 includes angioplasty procedure as well along with thrombectomy and/or thrombolysis in the dialysis circuit.

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When to use CPT code 36906, +36907, +36908 and +36909

Now, CPT code 36906 is coded for the thrombectomy and/or thrombolysis in dialysis circuit along with an intravascular stent placement. This codes includes angioplasty, angiography and RS&I, which are necessary to perform stent placement and angioplasty in the dialysis circuit. Do not report CPT code 36906 along with CPT code 36901,36902, 36903 and 36904.

The remaining CPT codes +36907, +36908 and +36909 are add-on codes. These all three add-on codes can be used along with CPT code 36901-36906. But, never use these add-on codes together. CPT code 36907 and 36908 should be coded only one per angioplasty and stenting within dialysis circuit. CPT code 36909 should be reported once per encounter per day. Hence, do remember these guidelines before using these CPT codes.

 

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