PTA with wire/dilators

[lward]

Physician uses a wire and dilators in the superficial femoral artery. He upsizes the dilators from a 6F, 8F, 10F with good results. My question, can I code this with 37224 with the use of the wire and dilator instead of a balloon?

[jmcpolin]

Angioplasty is dilation by any means not just a balloon.

[dpeoples]

Originally Posted by lward

Physician uses a wire and dilators in the superficial femoral artery. He upsizes the dilators from a 6F, 8F, 10F with good results. My question, can I code this with 37224 with the use of the wire and dilator instead of a balloon?

I would not. What Jenifer has posted was perhaps true in the past but most current descriptions of angioplasty (actually transluminal angioplasty) include a balloon. The new revascularization codes just refer to "angioplasty" without specifically stating "balloon angioplasty" which might lead coders/providers to assume this includes "by any means". IMO, this is an error of assumption (that everyone knows angioplasty means balloon angioplasty) on the part of the writers and editors. One can undertand the great potential for misuse or upcoding based on using catheters or dilators alone. Just placing larger catheters for greater purchase (think "fit") could result in unwarranted angioplasty codes.

The question you should ask is " can I (or my provider) reasonably defend catheter upsizing as angioplasty to a federal authority?

I would be very interested in seeing the report in question.

HTH

[jmcpolin]

Thanks Danny for that explanation I agree with you there would need to be a certain amount of work involved.