ACOA Coding Minute


Medical Oncology Code Changes

ACOA’s Coding Corner – April 2006

Declotting a Vascular Device

Procedure code 36550 reports declotting of completely implanted devices and catheters. This procedure necessitates the use of a thrombolytic agent that is introduced through a syringe and then slowly instilled into the device or catheter. Code 36550 includes the instillation/push of the declotting agent, removal of the agent if required and flushing the port at the completion of the procedure.

Common thrombolytic agents include Urokinase, Alteplase and Reteplase, and the agent is coded in addition to the declotting procedure:

Injection, urokinase, 5000 IU vial

Injection, IV, urokinase, 250,000 I.U. vial

Injection, alteplase recombinant, 1 mg

Injection, Reteplase, 18.1 mg

In general, this service must be linked to an appropriate diagnosis code(s), such as:

996.74             Complications due to vascular device, or

996.62             Infection and inflammatory reaction due to vascular device, implant and graft, plus

E878.8             Surgical operation and other surgical procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at the time of operation, other specified surgical operations and procedures.

Watch for more coding changes in the upcoming months.  Review previous Coding and Reimbursement Updates.

This Coding and Reimbursement Update was prepared by:
Cindy C. Parman, CPC, CPC-H
Coding Strategies, Inc.

Phone: (877) 6CODING

Fax: (770) 445-0407

[email protected]

Cindy C. Parman, CPC, CPC-Hcparman-8047995
principal and co-founder of Coding Strategies, Inc. in Atlanta, GA. Cindy is a current member of the Advisory Board for the American Academy of Professional Coders (AAPC) and a faculty instructor for AMA Solutions, a subsidiary of the American Medical Association.  She serves as the Consulting Editor of the Radiology Coding Alert and is on the Editorial Advisory Board of General Surgery Coding Alert and Pain Management Coding Alert.