Appendix C: Terminology for Billing and Encounter Forms

INTRODUCTION

CPT-2010: Current Procedural Terminology Codes

• 36468: Single or multiple injections of sclerosing solutions, spider veins (telangiectasia); limb or trunk.

• 36469: Single or multiple injections of sclerosing solutions, spider veins, face

• 36470*: Injection of sclerosing solution, single vein, leg

• 36471*: Injection of sclerosing solution, multiple veins, same leg

• 36471-50*: Bilateral injection of sclerosing solution, multiple veins, two legs

While the nuances of CPT coding are beyond the scope of this book, the asterisk (*) means that the surgical code listed above includes only the surgical procedure of sclerotherapy. This means that an appropriate evaluation and management code (e.g., level of service if “significant identifiable services” were actually provided in addition to the procedure), new or established patient, with the modifier “-25” may be theoretically added to the bill. However, this terminology has no bearing on whether or not an insurance company will actually pay for the added E&M visit charge. Many do not.

• 37799: Unlisted procedure, vascular surgery.

• 37720: Ligation and stripping of great saphenous or small saphenous veins.

• 37785: Ligation, and/or excision of recurrent or secondary varicose veins (clusters), one leg.

• 93965: Noninvasive physiologic studies of extremity vein, complete bilateral study.

• 93970: Duplex scan of extremity vein, complete bilateral study.

• 93971: Duplex scan of extremity vein, unilateral or limited study.

Diagnosis Codes: ICD-9—CM

It is expected that an updated terminology text, ICD-10, will be released in 2012. No details are available as of mid-2011.

References for Appendix C