Question:

Do you have more insight into how we would code for arterial mechanical thrombectomy?

Answer:

Arterial mechanical thrombectomy is reported per vascular family using 37184 for the initial vessel treated and 37185 for the second or all subsequent vessel(s) within the same vascular family. Assign code 37185 only once within a single vascular family. If one or more arteries in a different vascular family are also treated with primary mechanical thrombectomy, assign 37184 and 37185 again as appropriate with modifier 51 or other modifiers as specified by the payer. Arterial mechanical thrombectomy is considered a “secondary” transcatheter procedure for removal or retrieval of short segments of thrombus or embolus when performed either before or after another percutaneous intervention (e.g., percutaneous transluminal balloon angioplasty, stent placement). Secondary mechanical thrombectomy may be called a rescue or bailout thrombectomy. As an example, a patient has had an angioplasty in the superior femoral artery (SFA), and the immediate post-procedure follow-up exam shows a clot in the previously open anterior tibial (AT) artery. Suction removal of that clot is considered a secondary mechanical thrombectomy. Do not assign 37184 or 37185 in addition to 37186 during the same session. If assigning the addon code bilaterally report in units, do not assign modifier 50 to the add-on code.

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