Ask Dr. Z

One of my providers went to a conference where he was told he could perform an atherectomy and secondary thrombectomy using the Auryon catheter and code for both. My understanding is if it is the same device in a distal vessel, you can't code both. They also said if it was a documented pre-existing thrombus you could code both. What is your opinion?

"Some Auryon (to include adjacent thrombus aspiration when treating stenoses in native & stented infrainguinal arteries) users have reported being paid for both thrombectomy & atherectomy when performed in the same vessel & clinical session. As with many emerging technologies, some payers may not pay for both when performed in the same treatment session. We encourage you to check with your particular payer for any coding, reimbursement, or billing questions that may arise. Current Medicare NCCI guidance says that secondary thrombectomy is inherent in the work of atherectomy and should not be separately reported. Some payers may defer to NCCI guidance, while others do not consider it in payment decisions."