Coding Kissing Stents

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Question:

I placed stents in the right and left common iliac arteries. I also did angioplasties of both vessels. Do I bill this as one stent and angioplasty or two?? And do I use the add-on code for the second side?

Answer:

Kissing stents, stents placed in bilateral common iliacs, are coded as two stents, 37211 and 37211-59. Although CPT tells us to use a 59 modifier in this situation, individual payors may request the bilateral modifier 50 instead. The add-on code for additional vessels (+37223) is used only for a second stent in the same leg; for example, a second stent in the ipsilateral external or internal iliac. Remember that the angioplasties are bundled, as well as the catheterization codes and any guidance or follow-up radiological supervision and interpretation.