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Question: My provider takes really specific notes during revascularization procedures, and I’m not sure whether to code any steps separately. Which aspects of revascularization procedures are bundled? 

California Subscriber

Answer: Revascularization procedures include angioplasties, atherectomies, and stenting.

An angioplasty is the simplest of the three, when the physician inserts and then inflates a balloon into the narrowed area of the artery, which flattens the plaque and widens the artery, improving blood flow.

An atherectomy involves a physician finding the blockage and using a catheter and a blade, laser, or rotating tool to physically minimize or remove hardened plaque from an artery.

A stent is a physical barrier, like a cylindrical piece of metal mesh, that a physician can insert into an artery to keep blood flowing and prevent the artery from narrowing again; this is often performed after an angioplasty. Revascularization codes are hierarchical, and in such a situation, only the stenting should be reported; the angioplasty should not be reported separately.

Although each procedure requires multiple steps, the following aspects are included in CPT^® codes for revascularization and shouldn’t be reported as separate procedures:

• Accessing and selectively catheterizing the vessel
• Traversing a lesion
• Radiological supervision interpretation directly related to the intervention
• Embolic protection, if used
• Closure of the arteriotomy by pressure and application or by some sort of closure device or standard closure by suture
• Imaging performed to document completion of intervention in addition to the intervention performed.

Rachel Dorrell, MA, MS, CPC-A, CPPM, Development Editor, ÐÇ¿ÕÈë¿Ú