Non-Coronary Vascular Stents: Renal artery

January 16th, 2018 - Find-A-Code
Categories:   CPT® Coding   Diagnosis Coding   Cardiology|Vascular  

The following information is according to Novitas Solutions L35084.

Renal artery: Stenting may be indicated for renal artery stenosis causing renovascular hypertension (see below) or renal insufficiency as well as post-transplant renal artery stenosis, arterial aneurysm or dissection. Renal artery angioplasty with or without stenting is covered for renal artery stenosis manifested by at least one of the following conditions:

  • Recurrent (“flash”) pulmonary edema without cardiac or other obvious etiology and with renal artery stenosis of greater than or equal to 60 percent of the vessel diameter.
  • Rapidly progressive renal insufficiency or acute renal failure in patients at risk for renal artery stenosis when another cause for renal deterioration has been sought and is not present, and with renal artery stenosis of greater than or equal to 75 percent of the vessel diameter and with one of the following in addition to progressive renal insufficiency:
    • Coexisting diffuse atherosclerotic vascular disease.
    • Acute renal failure precipitated by antihypertensive therapy, particularly angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers.
  • Renal artery dissection.
  • Renal artery aneurysm.
  • Renal artery stenosis greater than or equal to 50 percent in a transplanted kidney. 

Renovascular hypertension (all criteria must be met):

  • Hypertension is not controlled (lowest blood pressure recorded by a physician of 160 mm Hg systolic or 90 mm Hg diastolic or 160 mm Hg in patients with isolated systolic hypertension despite documented adherence to treatment with maximum accepted doses of three or more antihypertensive medications.
  • Renal artery stenosis demonstrated by renal arteriography with luminal cross-sectional area reduction of 75 percent or vessel diameter narrowing greater than 50 percent. Stenting of renal artery stenosis of less than 75 percent reduction of luminal cross-sectional area/50 percent reduction of vessel diameter may be indicated when renal vein renin studies clearly indicate renal artery stenosis to be the cause of the elevated blood pressure.
Medicare is establishing the following limited coverage for CPT/HCPCS codes 37236 and 37237:

CPT codes:

ICD-10-CM codes:
  • I70.1* - Atherosclerosis of renal artery
  • I72.2 - Aneurysm of renal artery
  • I75.81 - Atheroembolism of kidney
  • I77.3* - Arterial fibromuscular dysplasia
  • I77.73 - Dissection of renal artery
  • Q27.1 - Congenital renal artery stenosis
  • Q27.2 - Other congenital malformations of renal artery
  • Q27.34 - Arteriovenous malformation of renal vessel
  • Kidney transplant
*Note: I70.1 and I77.3 require an additional code for coverage of renal artery stenting. These codes fulfill medical necessity:
  • Hypertensive chronic kidney disease
    • I12.0 - with stage 5 chronic kidney disease or end stage renal disease
    • I12.9 - with stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease
  • Hypertensive heart and chronic kidney disease
    • I13.0 - with heart failure and stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease
    • I13.10 - without heart failure, with stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease
    • I13.11 - without heart failure, with stage 5 chronic kidney disease, or end stage renal disease
    • I13.2 - with heart failure and with stage 5 chronic kidney disease, or end stage renal disease
  • I15.0 - Renovascular hypertension
  • I15.1 - Hypertension secondary to other renal disorders
  • J81.0 - Acute pulmonary edema
  • N17.8 - Other acute kidney failure
  • N17.9 - Acute kidney failure, unspecified
  • N26.2 - Page kidney


Questions, comments?

If you have questions or comments about this article please contact us.  Comments that provide additional related information may be added here by our Editors.

Latest articles:  (any category)

COVID Vaccine Coding Changes as of November 1, 2023
October 26th, 2023 - Wyn Staheli
COVID vaccine changes due to the end of the PHE as of November 1, 2023 are addressed in this article.
Medicare Guidance Changes for E/M Services
October 11th, 2023 - Wyn Staheli
2023 brought quite a few changes to Evaluation and management (E/M) services. The significant revisions as noted in the CPT codebook were welcome changes to bring other E/M services more in line with the changes that took place with Office or Other Outpatient Services a few years ago. As part of CMS’ Medicare Learning Network, the “Evaluation and Management Services Guide” publication was finally updated as of August 2023 to include the changes that took place in 2023. If you take a look at the new publication (see references below),....
Can We Score Interpretation of an EKG Towards E/M Medical Decision Making?
October 10th, 2023 - Aimee Wilcox
When EKGs are performed in the facility setting or even in the physician's office, what are the requirements for reporting the service and who gets credit for scoring data points for Evaluation and Management (E/M) medical decision making (MDM)? Let's take a look at a few coding scenarios related to EKG services to get a better understanding of why this can be problematic.
Accurately Reporting Signs and Symptoms with ICD-10-CM Codes
October 5th, 2023 - Aimee Wilcox
Coders often find themselves unsure of when to report a sign or symptom code documented in the medical record. Some coders find their organization has an EHR that requires a working diagnosis, which is usually a sign or symptom, be entered to order a test or diagnostic study or image. Understanding the guidelines surrounding when signs and symptoms should be reported is the first step in correct coding so let's take a look at some scenarios.
The 2024 ICD-10-CM Updates Include New Codes for Reporting Metabolic Disorders and Insulin Resistance
September 19th, 2023 - Aimee Wilcox
Diabetes is a chronic disease that just seems to consistently be increasing instead of improving resulting in a constant endeavor by medical researchers to identify causal effects and possible treatments. One underlying or precipitating condition that scientists have identified as a precipitating factor in the development of diabetes is insulin resistance, which is a known metabolic disorder. As data becomes available through claims reporting, additional code options become possible with ICD-10-CM.
Documenting and Reporting Postoperative Visits
September 12th, 2023 - Aimee Wilcox
Sometimes we receive questions regarding documentation requirements for specific codes or coding requirements and we respond with information and resources to support our answers. The following question was recently submitted: Are providers required to report postoperative services on claims using 99024, especially if there is no payment for that service? What documentation is required if you are reporting an unrelated Evaluation and Management (E/M) service by the same physician during the postoperative period? 
Understanding Gastroesophageal Reflux Disease and ICD-10-CM Coding
August 22nd, 2023 - Aimee Wilcox
Gastroesophageal reflux disease or GERD for short, is a disease that impacts millions of Americans on a weekly basis. Symptoms are uncomfortable, as are some of the tests used to diagnose it, but understanding the disease, tests, and treatments helps us better understand how to code the disease using ICD-10-CM codes.

Home About Terms Privacy

innoviHealth® - 62 E 300 North, Spanish Fork, UT 84660 - Phone 801-770-4203 (9-5 Mountain)

Copyright © 2000-2023 innoviHealth Systems®, Inc. - CPT® copyright American Medical Association