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SECOND REQUEST-BARD ROTAREX ATHERECTOMY/THROMBECTOMY

Date: May 26, 2021

Question:

We are still having debates on the compliant coding of the Rotarex device. According to the NCCI this should be atherectomy only (37225 see example) - in the beginning the Rotarex coding team told them to report code 37184 with 37225, and now they are telling them to code 37186 instead with 37225. I interpret the NCCI edit to clearly state if in same vessel as intervention only the atherectomy should be coded? Example: DX; multiple areas of atherosclerosis/significant stenosis: "A Rotarex device was then prepped per routine and advanced to the lesion over a 0.018" wire. Primary mechanical atherectomy and secondary mechanical thrombectomy were performed in multiple passes in the SFA and popliteal arteries." (Then they stented.) Am I correct in coding only the atherectomy and not to bill secondary thrombectomy with a modifier? Since the start of the use of the Rotarex and their suggested coding, I can get no one from Rotarex to respond to discuss their suggested coding with me.

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