December 15, 2016

Question:
Thank you for the discussion yesterday! You are very insightful and a great educator on a complex topic.  I have a question for you regarding treating vasospasm extracranially (not intracranially). Can I also use 61650 for a catheter that causes vasospasm on the way up to coil an aneurysm?

Answer:
There are a few issues with using 61650 in the situation you describe.  First, 61650 is for treating intracranial vasospasm – in your example below the vasospasm is extracranial so 61650 cannot be used.

Also, there is no longer a peripheral code for treating vasospasm. That code 37202, non-thrombolytic infusion, was deleted in 2015.  There was no replacement code because it is rarely appropriate to separately code the vasospasm treatment in the peripheral vascular system.

Lastly, if the catheter to treat an aneurysm causes the vasospasm, then we would not separately code for treating the vasospasm because you’re billing for the aneurysm coiling (61624).

*This response is based on the best information available as of 12/15/16.