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Bilateral renal artery stent placement - 37236, 37237 or 37236-50?

Date: Dec 6, 2023

Question:

Should bilateral renal artery stent placement be reported as 37236, 37237, or 37236-50? We understand that past guidance (such as from question IDs 5462 and 8218) states to use 37236, 37237 in this given scenario. The rationale given in Question ID 8218 was that modifier -50 “applies to lower extremity revascularizations, but not to renal, visceral, [or] upper extremities”. However, code 37236 is a "conditional bilateral" code as per CMS, meaning that modifier -50 is applicable to it. Is this to say that modifier -50 is only applicable to code 37236 when lower extremity revascularization of non-occlusive disease is performed? Or, should it apply to any applicable anatomy that has bilaterality, such as the renal arteries?

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