CPT’s definition of a ‘single vessel’ for this territory is an exception to the rule.

CPT 2011 adds new codes for lower extremity endovascular revascularization covering angioplasty, atherectomy, and stenting, noted Stacy Gregory, CCC, CPC, RCC, of Gregory Medical Consulting Services, in her presentation, “Peripheral Vascular Coding Tactics,” at the 2011 Coding Update and Reimbursement Conference in Orlando (www.codingconferences.com).

This article focuses on the femoral/popliteal codes 37224-37227. “37220 to +37223 Revamp Your Iliac Intervention Coding Options” in Cardiology Coding Alert discussed the iliac codes. Look to a future issue to cover tibial/peroneal codes 37288-+37235.

The new femoral/popliteal service codes are below. Note that all of the codes include angioplasty in the same vessel when that service is performed:

• Angioplasty: 37224 — Revascularization, endovascular, open or percutaneous, femoral/popliteal artery(s), unilateral; with transluminal angioplasty
• Atherectomy (and angioplasty): 37225 — … with atherectomy, includes angioplasty within the same vessel, when performed
• Stent (and angioplasty): 37226 — … with transluminal stent placement(s), includes angioplasty within the same vessel, when performed
• Stent and atherectomy (and angioplasty): 37227 — … with transluminal stent placement(s) and atherectomy, includes angioplasty within the same vessel, when performed.

The general rule for 37224-37227 is that you should report the one code that represents the most intensive service performed in a single lower extremity vessel. All lesser services are included in that one code.

When the cardiologist performs a stent placement, atherectomy, and angioplasty in the left popliteal vessel, you should report only 37227.

That code covers stent placement, atherectomy, and angioplasty. You should not report 37224 (angioplasty), 37225 (atherectomy), or 37226 (stent placement) separately or in addition to 37227 in this scenario.

As explained in the last issue of Cardiology Coding Alert, CPT guidelines state that — in addition to the intervention performed...

Stop worrying if your claims were denied, you still hold a chance as many carriers are reprocessing.

Almost a year ago, practices were told that Medicare will cover an annual wellness visit (AWV) for Part B beneficiaries effective Jan. 1 and last month, CMS announced the new codes for the AWVs. Everything seemed to look perfect until came the time for claims submissions and came the denials along with it.

The MACs may have hit a few speedbumps while processing the first of the AWV claims, but are attempting to get their systems rolling smoothly as January closes out for codes G0438 (Annual wellness visit, initial) and G0439 (Annual wellness visit, subsequent). We give you answers to several questions — straight from the MACs themselves — which may help you ensure that your claims go through smoothly.

Which Diagnosis Code Should You Use?

Several subscribers have told the Insider that they submitted their AWV claims using ICD-9 code V70.0 (Routine general medical examination at a health care facility), but faced immediate denials due to MACs claiming that this is the wrong diagnosis code.

It appears that those denials were the result of a computer glitch that made the AWV codes non-payable when billed with V70.0, but some payers have already fixed this problem.

National Government Services, a Part B payer in four states, sent out a notification on Jan. 25 stating that they “omitted the editing for diagnosis code V70.0 that is allowable with HCPCS codes G0438 and G0439, and claims that were initially denied are being reprocessed.

Pinnacle Business Solutions, a Part B MAC in two states, ran a notification on its Web site on Jan. 21 stating that a system error in the claims processing system incorrectly denied claims for G0438-G0439 between Jan. 1 and Jan 20. “A...