Billing and Coding: Endovascular Management for Peripheral Arterial Disease of the Upper and Lower Extremities

Endovascular management for peripheral arterial disease of the upper and lower extremities is covered when an individualized, patient-centered decision supports endovascular over open or hybrid revascularization; anatomically less-complex lesions in claudication or CLTI are typically managed endovascularly. Documentation must include decision-making rationale, autologous vein availability (>3 mm preferred if required), comorbidities (CAD, COPD with oxygen dependence, CKD/dialysis, diabetes with HbA1c and insulin status), functional and ambulatory status, frailty, living situation, nutritional status, prior procedures, and perioperative risk; complex anatomy requires a face-to-face justification. Imaging should not be performed before the clinical decision to intervene, and billing is limited to POS codes 11, 21, 22, and 24.

"Endovascular revascularization is appropriate when the individualized, patient-centered clinical decision favors endovascular over open or hybrid revascularization for peripheral arterial disease o..."