Primary procedure code for 37252

We received a rejection back from medicare stating that procedure code 37252 can't be bill without the primary procedure code. I was told by our coder that procedure code 37238 and 75820 is considered our primary code for 37252.

Procedure: Left common femoral vein access under ultrasound guidance, venogram left lower extremity this was pre and post intervention, intravascular ultrasound pre and post-intervention stent placement using a 20 x 90 mm Wallstent deployed distally as far as the left common femoral vein underneath the inguinal ligament post-dilated with an 18 mm balloon with excellent angiographic result.

Findings: No evidence of common iliac vein obstruction or external illac vein obstruction; however, the left common femoral vein had evidence of at least 50% stenosis angiographically at the level of the inguinal ligament. This was confirmed with intravascular ultrasound. The area was reduced by 80%. The average diameter was approximately 18 mm. The stent was placed and angiography and intravascular ultrasound revealed resolution of the stenosis. 5000 units of heparin were given pre-intervention. Protamine was given 10 units post-intervention.


We billed the following:
75820-2659
37250
75945-2659
37251
37251-59
75946-2659
75946-2659
37238
36012-LT
36012-LT59
36012-LT59

Is 37238 and 75820 a primary procedure code for 37250?
Also, I was told that 36012-LT, 36012-LT59 and 36012-LT59 is incorrect and to bill 36005 for 1 unit, is that correct?

Thanks
Rhonda

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