On Demand: Navigating the New CPT Structure for Lower Extremity Revascularization-Webinar Recording

Video Transcription

Video Summary

The video transcript details a comprehensive educational session on the 2026 CPT coding updates for lower extremity vascular interventions, presented by Jolene and her colleague Tammy Barron. The session covers angiography techniques, coding nuances, and new distinctions in coding vascular territories and procedures related to the iliac, femoral-popiteal, tibial, and inframalleolar arteries.<br /><br />Key points include a review of lower extremity angiography access approaches (antegrade, retrograde, contralateral, etc.) and the importance of coding selective catheterizations over non-selective ones. The presenters emphasize that each leg is considered a separate vascular family, with specific rules about coding initial and additional vessels treated for angioplasty, stenting, atherectomy, and lithotripsy. They clarify that atherectomy codes require actual use of devices like lasers or rotational blades—not cutting balloons.<br /><br />New for 2026 is the recognition of four vascular territories: iliac, femoral popliteal, tibial peroneal, and inframalleolar, each with defined vessels and add-on codes for distinct lesions in separate vessels. Lesions are categorized as straightforward or complex (complex equating to occlusions or near occlusions with absence of flow). The coding hierarchy favors stents over angioplasty, and atherectomy with stent is highest.<br /><br />The session also covers coding for diagnostic angiography, IVUS procedures, embolization, thrombolysis, moderate sedation, and ultrasound guidance for vascular access, stressing documentation requirements for proper coding. Several detailed real-world case studies illustrate coding decisions based on procedure details, catheter access, lesion location, and documented lesion severity.<br /><br />Moderator questions clarify topics such as performing staged procedures, the treatment of crossing lesions, billing for unsuccessful crossing attempts as diagnostic, and practical tips for authorization requests given the complexity of codes. The presenters stress the importance of provider documentation accuracy and collaboration for correct coding and billing. Overall, the session equips coders and providers with detailed guidance on navigating the updated 2026 CPT corrections, helping ensure precise procedural coding and reimbursement compliance.

Keywords

2026 CPT coding updates

lower extremity vascular interventions

angiography techniques

iliac artery coding

femoral-popliteal artery

tibial artery

inframalleolar artery

selective catheterization

atherectomy coding

vascular territories

angioplasty and stenting

diagnostic angiography

provider documentation accuracy