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POLICYThe physician places an intravascular stent(s) percutaneously through a catheter into a blood vessel (other than a coronary, carotid, or vertebral vessel). A guidewire is threaded through the needle into the blood vessel and the needle is removed. A catheter with a stent-transporting tip is threaded over the guidewire into the vessel, and the wire is extracted. The catheter travels to the point where the vessel needs additional support. The compressed stent(s) is passed from the catheter out into the vessel, where it deploys, expanding to support the vessel walls of the vessel.
According to CPT coding guidelines, one unit is reported for each vessel/vein treated with stents. The number of vessels/veins treated is counted, not the number of stents deployed in each vessel/vein. For example, if two stents are placed in a single vessel/vein, only one unit is reported. Likewise, if one stent is used to treat two vessels/veins, two units are reported.
Per the CPT descriptor for codes 37205 and 37206, the initial vessel/vein treated should be reported using procedure code 37205. Each additional vessel/vein treated should be coded to procedure code 37251.
When radiological supervision and interpretation for stent placement is also performed, code 75960 should be reported. Code 75960 is reported one time for each vessel/vein treated. The number of units reported for code 75960 should equal the sum of units reported for codes 37205 and 37206.
If procedure codes 75960 is performed in a facility, modifier -26 (professional component ) should be appended.
POLICY GUIDELINESThe coding guidelines outlined in Coding Policy should not be used in lieu of the Member's specific benefits plan language.
POLICY HISTORY3/2007: Policy developed