Cardiology Coding Alert

Question: My cardiologist's documentation indicates, "The patient underwent a peripheral angioplasty with cryoplasty balloon of critical stenosis in the distal left SFA and left popliteal artery." He accessed the vessel from the right femoral artery access site. How should I report this?Georgia SubscriberAnswer: For the superficial femoral artery (SFA) intervention, you can report 35474 (Transluminal balloon angioplasty, percutaneous; femoral-popliteal) and 75962-26 (Transluminal balloon angioplasty, peripheral artery, radiological supervision and interpretation; professional component).Assuming that these two interventions address separate lesions (rather than one lesion that overlaps the two vessels), you would also need to code for the popliteal PTA with 35474-59 (Transluminal balloon angioplasty, percutaneous; femoral-popliteal; distinct procedural service) and +75964-26 (Transluminal balloon angioplasty, each additional peripheral artery, radiological supervision and interpretation [list separately in addition to code for primary procedure]).
Watch for: The contralateral popliteal cath placement is 36247 (Selective catheter placement, arterial system; initial third order or more selective abdominal, pelvic, or lower extremity artery branch, within a vascular family). Therefore, you should not separately report any lesser order cath placement codes (36140, 36200, 36245 and 36246) for this intervention.