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Answer: "Kissing balloon angioplasty" refers to a technique in which the contralateral artery (in this case, the iliac) is angioplastied at the same time as the ipsilateral iliac artery, typically due to an ostial lesion. The technique is used to prevent treatment in one artery from worsening the lesion in the other artery.
In this case, the operative session would be coded:
37205 Transcatheter placement of an intravascular stent(s), (non-coronary vessel), percutaneous; initial vessel
37206 each additional vessel (list separately in addition to code for primary procedure)
35473-50 Transluminal balloon angioplasty, percutaneous; iliac; bilateral procedure
36245-50 Selective catheter placement, arterial system; each first order abdominal, pelvic, or lower extremity artery branch, within a vascular family; bilateral procedure
75716-26 Angiography, extremity, bilateral, radiological supervision and interpretation; professional component
75960-26 Transcatheter introduction of intravascular stent(s), (non-coronary vessel), percutaneous and/or open, radiological supervision and interpretation, each vessel; professional component
75962-26 Transluminal balloon angioplasty, peripheral artery, radiological supervision and interpretation; professional component
75964-26 Transluminal balloon angioplasty, each additional peripheral artery, radiological supervision and interpretation (list separately in addition to code for primary procedure); professional component.
Report 36245 as a bilateral procedure using modifier -50 (to cover both catheter placements from the femoral to the common iliac artery) and 75960-26 twice (since two stents are performed in two vessels).
Code 75716 is used to report the angiogram performed after the catheters are placed.
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