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Oct 16th, 2017 - jmoon 2 

CPT Code for Transcatheter Balloon Angioplasty of all four pulmonary veins

May I request assistance in locating the CPT code for Trans catheter Balloon Angioplasty of all four pulmonary veins - 2 Right Pulmonary Veins and 2 Left Pulmonary Veins. Heart catheterization was done with Trans catheter Balloon Angioplasty of all four pulmonary veins. The patient is 19 months old with residual pulmonary vein stenosis after TAPVR repair. I came up with CPT 93533 and 35476, but I am uncertain if CPT 35476 may be assigned more than once perhaps with a modifier? The procedure was done in September of 2016 before 35476 was deleted from the CPT book..

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Oct 24th, 2017 - ChrisW   39  1 

re: CPT Code for Transcatheter Balloon Angioplasty of all four pulmonary veins

CPT Assistant Archives - Peripheral Vascular Changes: CPT 2012 Overview (April 2012), states 35476 may only be reported once, even if one or more central veins are treated. CPT assist covers many situations where angioplasty and stenting codes should be reported only once.
When reporting the perihereral zone this includes the graph and the peripheral extremity veins

You may code only one venoplasty per zone of intervention. There are two zones:
The peripheral zone includes the graft and peripheral extremity veins up to and including the axillary vein
The central zone includes the subclavian, brachiocephalic, and superior vena cava

For venoplasty in either zone, use codes 35476 and 75978. If the physician performs both a central zone venoplasty and a peripheral zone venoplasty, add modifier -59 (distinct procedural service) to the second set of codes to show that they represent a separate procedure. The central venoplasty must be a separate and distinct procedure to add modifier -59.

2017 made it easier with an add on code for each additional artery using 37247. If anyone else has more information please let us know.

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