Vascular Access Coding Stays Same

The Centers for Medicare and Medicaid Services decided against coding edits that would have changed the way vascular access procedures are billed.

Coding guardians at the American Society of Diagnostic and Interventional Nephrology (ASDIN) and other industry groups formed a coalition that succeeded in keeping certain codes and definitions unchanged.

A Medicare coding program, the National Correct Coding Initiative, proposed changes that would have bundled the HCPCS codes G0392 and G0393. (During a percutaneous transluminal balloon angioplasty at a hemodialysis access site, if access to the “vessel” for the procedure is through an artery, code G0392 should be reported, and if access is through a vein, code G0393 should be reported.) The industry coalition argued that the codes should remain separate. As separate codes, they can still be billed together for the procedure in certain circumstances.

The coalition also successfully fought against creating a new definition of an arterial versus venous angioplasty, and against ending the use of code 35476 for draining a forearm fistula. Code 35476 generally is for a separate procedure outside of the fistula or graft location. Angioplasty may be coded a second time, with clear documentation, when a separate procedure is needed at a different site.