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Superb tips for coding Intravascular Vena Cava Filter

An inferior vena cava (IVC) filter is placed most commonly for refractory deep vein thrombosis and pulmonary embolism or when anticoagulation is contraindicated.  We have different procedure codes for insertion, removal and retrieval of intravascular vena cava filter.  The physician uses a needle to take access in the femoral (or internal jugular) vein and then advances a guide wire through this needle. The physician then passes the filter through the introducer sheath into the IVC under guidance. Fluoroscopic guidance is used generally for these procedures.  The physician removes the sheath once the IVC filter is placed in correct position. We have different CPT codes for IVC filter placement, removal and retrieval, which are used very frequently in interventional radiology.

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Superb tips for coding Intravascular Vena Cava Filter

CPT codes for Intravascular Vena Cava filter

There are three common CPT codes used for IVC filter. We have separate code for insertion, removal and retrieval of IVC filter. These CPT codes have all the small procedures included in them. Below are the CPT codes used for IVC filter

37191 – Insertion of intravascular vena cava filter, endovascular approach including vascular access, vessel selection and radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance (ultrasound and fluoroscopy), when performed.

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37192 – Repositioning of intravascular vena cava filter, endovascular approach including vascular access, vessel selection and radiological supervision and interpretation, intraprocedural roadmapping and imaging guidance (ultrasound and fluoroscopy), when provided.

37193 – Retrieval (removal) of intravascular vena cava endovascular approach including vascular access, vessel selection, and radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance (ultrasound and fluoroscopy), when performed.

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Do and Don’t with CPT code for IVC filter

The CPT code 37191, 37192 and 37193 includes the conscious sedation. Moderate conscious sedation should not be coded separately.

Do not code any guidance separately with CPT code 37191, 37192 and 37193. These codes includes all the respective guidance like ultrasound or fluoroscopic done during these procedures.

Never code CPT code 37192 with 37191. Insertion and Repositioning of IVC filter should not be coded together.

Do not code 37193 with 37197

Do not code Supervision and Interpretation CPT Codes with these procedures. All S&I codes are included with CPT codes 37191, 37192 and 37193.

Catheterization of vessel is included with CPT codes 37191, 37192 and 37193 and hence should not be coded separately