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Medical & Coding Policies
Provider Network Application
Out-of-State & Non-Network
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POLICYIntravascular ultrasound (IVUS) is the use of ultrasonic guidance and imaging during an intravascular procedure. IVUS is used before and after a therapeutic intervention on a non-coronary artery or vein to assess patency (check to see if the vein or artery is open) and integrity (no puncture wound, tearing, etc.) of the vessel.According to CPT coding guidelines, IVUS should be counted per vessel or per vein. For example, if IVUS is performed in four vessels/veins, four units should be reported for this procedure. If IVUS is performed before and after a procedure in four vessels/veins, only four units should be reported. Only one unit is reported per vessel/vein during an operative session. Per the CPT descriptor for codes 37250 and 37251, procedure code 37250 is used to report the initial vessel/vein treated. Each additional vessel/vein treated should be reported using procedure code 37251. When the radiological supervision and interpretation for IVUS is also performed, codes 75945 and 75946 should be reported in addition to codes 37250 and 37251. The units for codes 75945 and 75946 are counted in the same manner as the units are counted for codes 37250 and 37251. Count the number of vessels/veins treated, not the number of times IVUS is performed in each vessel/vein. Per the CPT descriptor for codes 75945 and 75946, procedure code 75945 is used to report the initial vessel/vein treated. Each additional vessel/vein treated should be reported using procedure code 75946. The number of units reported for code 75946 should equal the number of units reported for code 37251. If procedure codes 75945 and 75946 are performed in a facility, modifier -26 (professional component ) should be appended. |
| POLICY EXCEPTIONS None |
| POLICY GUIDELINES The coding guidelines outlined in Coding Policy should not be used in lieu of the Member's specific benefits plan language. |
| POLICY HISTORY 3/2007: Policy developed |
