Multiple codes in one territory
Angioplasty and stent billed separately in the same femoral-popliteal segment. Core MB codes each territory with the single most intensive code and separates territories with the correct documentation.
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Vascular surgery medical billing services
Vascular surgery billing spans open and endovascular operations, dialysis access, venous procedures and the vascular laboratory. Payment turns on territory-based coding rules, on what is already bundled into each intervention, and on documentation of conservative therapy for vein work. Each component has its own payer policies and its own edits.
What makes vascular surgery billing different
Vascular billing is governed by a handful of rules that do not exist in other surgical specialties.
- Lower extremity revascularization codes 37220 through 37235 are reported once per vascular territory, iliac, femoral-popliteal or tibial-peroneal, using the most intensive service performed there, and they include selective catheterization and imaging.
- Dialysis circuit codes 36901 through 36909 bundle all catheterization, imaging and angioplasty within the circuit, with 36907 and 36908 as add-ons for central segment work and 36909 for embolization.
- Vein ablations bill 36475 or 36478 for the first vein and 36476 or 36479 for additional veins, 36482 and 36483 for adhesive closure, and payers require documented reflux on duplex and a trial of compression therapy.
- Vascular lab studies 93880, 93922 through 93931 and 93970 or 93971 split into TC and 26 components, and the interpreting physician bills 26 only when the practice does not own the equipment.
Denials we see most in vascular surgery
Every denial gets a root cause, a fix and a feedback loop, so the same denial stops coming back.
Vein ablation not medically necessary
No record of compression trial, symptom duration or duplex reflux measurements. Core MB builds the conservative therapy timeline into the authorization and cites the payer's vein policy on appeal.
Vascular lab study denied
Duplex ordered without a qualifying diagnosis or accreditation on file with the payer. Core MB maps diagnoses to local coverage determinations and keeps lab accreditation credentials current with each payer.
How Core MB bills for vascular surgery
Core MB codes vascular cases from the procedure note and angiographic findings, separates territory, circuit and lab components correctly, and tracks authorizations for elective vein and endovascular work. Vascular lab accreditation records and surgeon credentialing live in the same client portal. Credentialing for new providers runs in the same system, tracked live in your client portal.
- Endovascular notes are mapped to a territory worksheet before coding so each segment is billed once at the right intensity.
- Vein procedures are scheduled only after the compression trial, duplex findings and authorization are verified in the record.
- Vascular lab claims are split and billed by place of service and equipment ownership with the correct TC and 26 modifiers.
Everything in the service
Core MB provides the complete billing service for vascular surgery, from verification and coding review through follow-up, denial work, posting, patient statements and reporting.
- Insurance verification and eligibility checks
- Charge entry and specialty-specific coding review
- Claim scrubbing and electronic submission
- Payer follow-up on every open claim
- Denial management and appeals
- Payment posting and reconciliation
- Accounts receivable recovery
- Patient statements and balance support
- Monthly reporting you can read in five minutes
- Provider credentialing and payer enrollment
Vascular surgery billing questions
How is an angioplasty and stent in both the iliac and the superficial femoral artery coded?
Each territory gets one code at the highest intensity performed there: 37221 for iliac stent placement and 37226 for femoral-popliteal stent. Additional vessels within the same territory use the add-on 37222 or 37223 for iliac only. Core MB verifies the vessel-by-vessel documentation before assigning codes.
Why do Medicare Advantage plans keep denying our dialysis access interventions?
Most require the referring nephrologist's access dysfunction findings, such as reduced flow or elevated venous pressure, in the record. Core MB attaches the clinical indication to the claim, confirms the correct 36902 through 36906 code for the intervention level, and appeals with the flow data.
What do we need to document for carotid stenting to be covered?
Medicare coverage for carotid artery stenting requires a shared decision-making discussion recorded before the procedure, stenosis documentation and performance at a facility meeting the coverage requirements. Core MB checks each element against the national coverage determination before the case bills with 37215.
How do we get started with Core MB for vascular surgery billing?
Submit the quote form with your procedure mix, vascular lab setup and current billing platform. Core MB maps your endovascular, access, venous and lab workflows and runs the transition alongside your current billing. Credentialing for new vascular surgeons and lab accreditation enrollment can start at the same time.
Vascular billing coded by territory, circuit and component
Core MB handles endovascular, open, dialysis access, venous and vascular lab claims with the specific coding rules and payer policies each requires.