Variation in thromboembolic complications among patients undergoing commonly performed cancer operations

Abstract

9 w 9 d t a b l i o b s The combined CPT and American Medical Association/ Specialty Society Relative Value Scale Update Committee (or RUC) Five-Year Review Identification Workgroup screened CPT codes billed together 75% or more of the time. From this assessment, inferior vena cava (IVC) interruption (CPT code 37620) and the radiology supervision and interpretation for percutaneous placement of an IVC filter (CPT code 75940), as well as IVC interruption (CPT code 37620) and nonselective IVC catheterization (CPT code 36010), met the inclusion criteria. The specialty societies were required to bundle the two work efforts into new CPT code descriptions followed by re-evaluation of their associated reimbursement. The original code 37620 was appropriate to report two vastly different procedures: endovascular insertion of an IVC filter and open surgical ligation of the IVC. In 2012, four new CPT codes became valid through the efforts of the Society for Cardiac Angiography and Interventions, the American College of Radiology, the Society for Interventional Radiology, the American College of Surgeons, and the Society for Vascular Surgery, which bundle all catheter placements and associated diagnostic imaging with IVC filter placement and an entirely new code was created specific for open surgery. The specialty societies decided to create three new endovascular code descriptions which include (when performed): venous nonselective and selective catheter manipulation required to image the vena cava, iliac veins, and renal veins, filter deployment/manipulation/removal, postprocedure completion angiography, ultrasound guidance for venous access, intravascular ultrasound, and moderate sedation. However, they do not include transcatheter embolization, endovascular stent placement, thrombolysis infusion, venous mechanical thrombectomy, and transluminal angioplasty. CPT code 37191 describes insertion of a vena cava filter through any approach (eg, jugular or femoral). This descriptor is appropriate for deployment of a filter device in the superior vena cava, inferior vena cava, or