AMA Clinical Examples in Radiology - 2013 Issue 3 (Summer)
Bilateral Thrombolytic Infusion, Catheter Follow-Up and Therapy Cessation
Bilateral Thrombolytic Infusion, Catheter Follow-Up and Therapy Cessation Clinical History Extensive bilateral lower extremity deep vein thrombosis (DVT). Procedure Bilateral thrombolysis catheter follow-up. Cessation of thrombolysis on the right side and continuation of therapy on the left side. Transluminal mechanical thrombectomy and percutaneous transluminal angioplasty. Technique 37213 LT Contrast is injected through previously existing bilateral popliteal vein catheters and fluoroscopic images are obtained. This angiography demonstrated: Left: Improved flow but incomplete thrombolysis of clot burden in the left femoral vein. There is a small volume of residual clot in the left external iliac vein with persistent occlusion of the...
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Article Overview
This article explains how a complex bilateral venous intervention is documented and discussed for coding purposes. It addresses thrombolysis catheter follow-up, therapy cessation, mechanical thrombectomy, angioplasty, fluoroscopy reporting, and the use of laterality and bilateral modifiers in the context of CPT and HCPCS Level II guidance. It is most relevant to coders, billers, and radiology practices working with interventional venous procedures and procedure-day sequencing.
Why This Topic Matters
Interventional venous procedures often involve multiple services performed across both sides and across more than one treatment day. This article helps readers understand the scope of services documented in the case and the general reporting categories referenced by the source.
Article Sections
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Clinical History
Summarizes the patient context and the venous condition prompting the intervention.
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Procedure
Describes the overall interventional course, including catheter follow-up, thrombectomy, angioplasty, and changes in treatment between the two sides.
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Technique
Presents the procedural imaging and catheter-based findings used to support the documented intervention.
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Impression
Provides the post-procedure summary of vessel status and the overall treatment course.
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Fluoroscopy Time
States the fluoroscopy documentation associated with the case.
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How to Code
Explains the coding framework discussed for the case, including the general categories of services and reporting considerations.
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Discussion
Reviews the broader coding commentary related to venous thrombolysis, thrombectomy, angioplasty, modifiers, and quality reporting references.
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References
Lists source references cited by the article.
What You Will Learn
- The general scope of venous thrombolysis follow-up and therapy cessation discussed in the case
- How the article frames a bilateral lower-extremity venous intervention for coding review
- Which broad service categories are discussed alongside the procedure
- How laterality and bilateral reporting concepts are addressed at a high level
- What kinds of documentation elements are tied to fluoroscopy and quality reporting
Who Should Read This
- Medical coders
- Radiology coders
- Interventional radiology staff
- Billing specialists
- Compliance professionals
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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