It has been a few years since CPT has made any changes of note to the codes most commonly utilized by the phlebology practice. This has allowed us to stay blissfully unaware of the impact CPT updates can have. We wanted to bring to your attention the very important information added in this year’s edition.
- Under the header for sclerotherapy, 36468, 36470, and 36471 the CPT now states: “describes sclerotherapy of telangiectasia’s and/or incompetent veins. Ultrasonic guidance when used is separately reportable and not included”. It also states that when services are performed in the office setting, all materials and supplies are included. This includes the drug which is not separately reportable.
- Under the header for RF, Laser, and Mechanochemical Ablation it clearly states that tumescent is included, and when performed in an office setting all required supplies and equipment are included. Additionally is the statement that for catheter injection of a sclerosant use 37799, for catheter injection of an adhesive use 37799, and the biggest change of them all is: for add on codes 36474, 36476, and 36479, “the add-on codes for subsequent vein treated in the same extremity may only be reported once per extremity, regardless of the number of additional veins treated”.
Medicare has not updated their MUE’s (medically unlikely edits) to match the once per extremity language for add-on codes, but we expect that the January, 2017 release will reflect this update. (currently the units are listed a 2).
Please be sure to update your coding and billing staff of these changes so that your 2017 submissions can be in compliance with these guidelines.
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