Transvenous Intrahepatic Portosystemic Shunt (TIPS) Coverage, Coding and Reimbursement Overview — Hospital Outpatient/ASC 2019 Edition — All Reimbursement Amounts are Listed at National Unadjusted Medicare Rates and Do Not Include the 2% Sequestration Reduction Hospital Outpatient rates effective January 1, 2019 through December 31, 2019 PROCEDURE A CODING HCPCS/CPT® Code A APC SI B Rate C C1874 ---- N ---- Procedure Insertion of transvenous intrahepatic portosystemic shunt(s) (TIPS) (includes 37182 ---- C ---- venous access, hepatic and portal vein catheterization, portography with hemodynamic evaluation, intrahepatic tract formation/dilatation, stent placement and all associated imaging guidance and documentation) Revision of transvenous intrahepatic portosystemic shunt(s) (TIPS) (includes 37183 5192 J1 $4,679 venous access, hepatic and portal vein catheterization, portography with hemodynamic evaluation, intrahepatic tract recanulization/dilatation, stent placement and all associated imaging guidance and documentation) Vascular embolization or occlusion, inclusive of all radiological supervision and 37241 5193 J1 $9,669 interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; venous, other than hemorrhage (eg, congenital or acquired venous malformations, venous and capillary hemangiomas, varices, varicoceles) Selective catheter placement, venous system; second order, or more selective, 36012 ---- N ---- branch (eg, left adrenal vein, petrosal sinus) A. Listed are common procedures. Review CPT® coding guidelines, modifiers, and NCCI edits for these codes. Current Terminology (CPT®) is a registered trademark of the American Medical Association (AMA). Copyright 2019 AMA. All rights reserved. B. Status Indicators: C-Inpatient Procedure; J1-Hospital Part B Services Paid Through a Comprehensive APC; N-ltems and Services Packaged into APC Rates. C. Rates are from CY 2019 Hospital Outpatient Prospective Payment System Final Rule, CMS-1695-CN2, Centers for Medicare and Medicaid Services. *Per CMS-1695-FC, device-intensive procedures require the reporting of a device HCPCS code. Device code reporting requirements apply. REIMBURSEMENT B Device Code* Stent, coated/covered, with delivery system HOSPITAL OUTPATIENT REVIEW
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Transvenous Intrahepatic Portosystemic Shunt (TIPS)Coverage, Coding and Reimbursement Overview — Hospital Outpatient/ASC2019 Edition — All Reimbursement Amounts are Listed at National Unadjusted Medicare Rates and Do Not Include the 2% Sequestration Reduction
Hospital Outpatient rates effective January 1, 2019 through December 31, 2019
PROCEDUREA CODINGHCPCS/CPT®
CodeA APC SIB RateC
C1874 ---- N ----Procedure Insertion of transvenous intrahepatic portosystemic shunt(s) (TIPS) (includes 37182 ---- C ----venous access, hepatic and portal vein catheterization, portography with hemodynamic evaluation, intrahepatic tract formation/dilatation, stent placement and all associated imaging guidance and documentation)
Revision of transvenous intrahepatic portosystemic shunt(s) (TIPS) (includes 37183 5192 J1 $4,679venous access, hepatic and portal vein catheterization, portography withhemodynamic evaluation, intrahepatic tract recanulization/dilatation, stent placement and all associated imaging guidance and documentation)
Vascular embolization or occlusion, inclusive of all radiological supervision and 37241 5193 J1 $9,669interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; venous, other than hemorrhage (eg, congenital or acquired venous malformations, venous and capillary hemangiomas, varices, varicoceles)
Selective catheter placement, venous system; second order, or more selective, 36012 ---- N ----branch (eg, left adrenal vein, petrosal sinus)
A. Listed are common procedures. Review CPT® coding guidelines, modifiers, and NCCI edits for these codes. Current Terminology (CPT®) is a registered trademark of the American Medical Association (AMA). Copyright 2019 AMA. All rights reserved.B. Status Indicators: C-Inpatient Procedure; J1-Hospital Part B Services Paid Through a Comprehensive APC; N-ltems and Services Packaged into APC Rates.C. Rates are from CY 2019 Hospital Outpatient Prospective Payment System Final Rule, CMS-1695-CN2, Centers for Medicare and Medicaid Services.
*Per CMS-1695-FC, device-intensive procedures require the reporting of a device HCPCS code. Device code reporting requirements apply.
REIMBURSEMENTB
Device Code*Stent, coated/covered, with delivery system
HOSPITAL OUTPATIENT REVIEW
ASC rates effective January 1, 2019 through December 31, 2019
PROCEDUREA CODINGHCPCS/CPT®
CodeA Rate
Procedure Insertion of transvenous intrahepatic portosystemic shunt(s) (TIPS) (includes 37182venous access, hepatic and portal vein catheterization, portography with hemodynamic evaluation, intrahepatic tract formation/dilatation, stent placement and all associated imaging guidance and documentation)
Revision of transvenous intrahepatic portosystemic shunt(s) (TIPS) (includes 37183venous access, hepatic and portal vein catheterization, portography withhemodynamic evaluation, intrahepatic tract recanulization/dilatation, stent placement and all associated imaging guidance and documentation)
Vascular embolization or occlusion, inclusive of all radiological supervision and 37241 $4,058interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; venous, other than hemorrhage (eg, congenital or acquired venous malformations, venous and capillary hemangiomas, varices, varicoceles)
Selective catheter placement, venous system; second order, or more selective, 36012 Packagedbranch (eg, left adrenal vein, petrosal sinus)
A. Listed are common procedures. Review CPT® coding guidelines, modifiers, and NCCI edits for these codes. Current Terminology (CPT®) is a registered trademark of the American Medical Association (AMA). Copyright 2019 AMA. All rights reserved.B. Rates are from the CY 2019 Ambulatory Surgical Center Payment Final Rule, CMS-1695-CN2, Centers for Medicare and Medicaid Services.
Non-Covered
Non-Covered
REIMBURSEMENTB
AMBULATORY SURGERY CENTER (ASC)
salbright
Typewritten Text
REV011719PT
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