Wiki Stent Placement in Iliac Vein

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niharims

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Could you please suggest that where we can use 37228 and add con code 37229 as well as 37221 for the stent placement in iliac vein. we have patient who has a "Intial stent placement of the left external iliac vein" and another "Stent placement of the left common iliac vein". So should we code 37228 and 37229 in this case or we have to code 37221 - "Revascularization, endovascular, open or percutaneous, iliac artery, unilateral, initial vessel; with transluminal stent placement(s), includes angioplasty within the same vessel, when performed".
 
niharims said:
Could you please suggest that where we can use 37228 and add con code 37229 as well as 37221 for the stent placement in iliac vein. we have patient who has a "Intial stent placement of the left external iliac vein" and another "Stent placement of the left common iliac vein". So should we code 37228 and 37229 in this case or we have to code 37221 - "Revascularization, endovascular, open or percutaneous, iliac artery, unilateral, initial vessel; with transluminal stent placement(s), includes angioplasty within the same vessel, when performed".
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Stent placement in veins are coded with 37238 initial vein & 37239 each additional vein.
 
Herewith I have attached 2 patient's medical records. So could you please assist that which code is appropriate as per records.
Thank You.
 

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  • Medical Record - 2.pdf
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niharims said:
Herewith I have attached 2 patient's medical records. So could you please assist that which code is appropriate as per records.
Thank You.
Click to expand...
I do some IR coding but not a lot so I could be completely wrong with these. If you post these in the Interventional Radiology forum this is Jim Pawloski's area of experience so he should be able to help.

Case #1 - 37238, 36010, 37252, 76937,26, 75820,26
The way I was reading it was that there was only 1 stent placed that covered the EIV through to the CFV. If that's not the case and an additional stent was placed into the CFV then 37239 can also be coded.
There was no IVC finding reported so I went with 75820 instead of 75825.
I didn't code 37253 because when I looked into it, the reports I found state if pathology crosses more than one vessel, a single code would be reported.

Case #2 - 37238, 36010, 37252, 76937,26, 75825,26, 75820,26

I hope this helps but again this is not my area of expertise.
 
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