IVC Filters Get New Codes

CPT 2012 has added new codes for insertion, repositioning and removal of an intravascular vena cava (IVC) filter.

37191 - Insertion of intravascular vena cava filter, endovascular approach including vascular access, vessel selection and radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance (ultrasound and fluoroscopy), when performed.

37192 - Repositioning of intravascular vena cava filter, endovascular approach including vascular access, vessel selection and radiological supervision and interpretation, intraprocedural roadmapping and imaging guidance (ultrasound and fluoroscopy), when provided.

37193 - Retrieval (removal) of intravascular vena cava endovascular approach including vascular access, vessel selection, and radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance (ultrasound and fluoroscopy), when performed.

Per the code descriptor, 37191 is an all-in-one code and includes all elements.  Due to this, CPT has deleted IVC codes 37620 and 35940.  Catheterization codes 36010 (non-selective) and 36011-36012 (selective) are still valid but cannot be reported in conjunction with 37191 as catheter placement is included. Typically, IVC filters are placed in the inferior vena cava, but these codes will also apply to superior vena cava filters.

If the IVC filter requires repositioning, per CPT, report 37192 for this service. This code cannot be reported for repositioning during filter placement as this is not the intent of the code.  There is also a specific note in CPT which states “Do not report 37192 in conjunction with 37191.”

It has always been difficult to assign the correct code for removal of an IVC filter.  Some carriers want an “unlisted” code while others want code 75961 with code 37203.  For 2012, you can now report new code 37193 for removal.  This code is also an all-in-one code and the only code needed.