Question:

Why is a coronary aspiration thrombectomy considered a component of the intervention code but peripheral aspiration is not? Where in the CPT book does it say that non-coronary aspiration is the same as mechanical?

Answer:

According to the American Medical Association (AMA), the initial request for a code for coronary mechanical thrombectomy specified a system that included “a drive unit, pump, and foot pedal. The physician steps on a foot pedal to activate the catheter which is then withdrawn across the lesion in order to remove the intracoronary thrombus.”

The current CPT book includes the following note under 92973: “Do not report 92973 for aspiration thrombectomy.” On the other hand, the peripheral code request and description were not that specific. The code description for 37186 (provided below) even includes suction technique.

37186 Secondary percutaneous transluminal thrombectomy (eg, nonprimary mechanical, snare basket, suction technique), noncoronary, non-intracranial, arterial or arterial bypass graft, including fluoroscopic guidance and intraprocedural pharmacological thrombolytic injections, provided in conjunction with another percutaneous intervention other than primary mechanical thrombectomy (List separately in addition to code for primary procedure)

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