Wiki 36XXX & 7XXXX Coding - Vascular

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Someone help me please! I have the following op report --
I think I should be coding possibly 36140 or 36200 - NOT 36245
AND 75716

The patient was brought to the cardiac cath lab the right and left groins were prepared by standard sterile technique. 1% lidocaine solution injected into the right goin and a 6 French sheath introduced into the right femoral artery. A contra catheter was used for abdominal aortic angiogram and to obtain access to the contralateral iliac vessel.
Procedures:
Abdominal aortic angriogram
Nonselective right iliac angriogram with distal runoff
Selective right femoral angiogram with distal runoff
Attempt at percutaneous revascularization of a chronically occluded left superficial femoral artery.

Findings:
The distal abdominal aortic angriogram revealed patent abdominal aorta, bilateral common iliac vessels, bilateral external iliac and common femoral arteries.

Left side: The superficial femoral artery is completely occluded at its very origin and is reconstituted after the adductor canal as popliteal vessel. The profunda femoris is the dominant vessel that supplies collaterals. There is two-vessel runoff in the lower limb.

Right side: The superficial femoral artery has moderate disease up until the adductor canal. There is then a short segment of complete occlusion and the popliteal artery is reconstituted at its mid region. There is two-vessel runoff in the lower limb.
I used initially an advantage wire over a trailblazer catherter to negotiate the complete occlusion. I was able to cross the proximal and was able to navigate the wire and the catheter up to the distal end; at that time the wire took a subintimal course and therefore recannulization of the superficial femoral artery to the popliteal artery was not successful. I stopped the procedure in the wire and the catheter were removed. The long 7 French sheath was substituted for a short 7 Frenchsheath.

SOMEONE PLEASE HELP!
 
Someone help me please! I have the following op report --
I think I should be coding possibly 36140 or 36200 - NOT 36245
AND 75716

The patient was brought to the cardiac cath lab the right and left groins were prepared by standard sterile technique. 1% lidocaine solution injected into the right goin and a 6 French sheath introduced into the right femoral artery. A contra catheter was used for abdominal aortic angiogram and to obtain access to the contralateral iliac vessel.
Procedures:
Abdominal aortic angriogram
Nonselective right iliac angriogram with distal runoff
Selective right femoral angiogram with distal runoff
Attempt at percutaneous revascularization of a chronically occluded left superficial femoral artery.

Findings:
The distal abdominal aortic angriogram revealed patent abdominal aorta, bilateral common iliac vessels, bilateral external iliac and common femoral arteries.

Left side: The superficial femoral artery is completely occluded at its very origin and is reconstituted after the adductor canal as popliteal vessel. The profunda femoris is the dominant vessel that supplies collaterals. There is two-vessel runoff in the lower limb.

Right side: The superficial femoral artery has moderate disease up until the adductor canal. There is then a short segment of complete occlusion and the popliteal artery is reconstituted at its mid region. There is two-vessel runoff in the lower limb.
I used initially an advantage wire over a trailblazer catherter to negotiate the complete occlusion. I was able to cross the proximal and was able to navigate the wire and the catheter up to the distal end; at that time the wire took a subintimal course and therefore recannulization of the superficial femoral artery to the popliteal artery was not successful. I stopped the procedure in the wire and the catheter were removed. The long 7 French sheath was substituted for a short 7 Frenchsheath.

SOMEONE PLEASE HELP!
It sounds the catheter was advanced into the superficial femoral 36247. You can query the doctor where the catheter was stopped at before you assign CPT code.
 
Last edited:
It sounds the catheter was advanced into the superficial femoral 36247. You can query the doctor where the catheter was stopped at before you assign CPT code.
Ok, so just to make sure....even though the procedure was stopped in the SFA we are still able to code this way because that is the furthest point the cath made it? I want to make sure I understand--
Thank you so much for your time
 
Ok, so just to make sure....even though the procedure was stopped in the SFA we are still able to code this way because that is the furthest point the cath made it? I want to make sure I understand--
Thank you so much for your time
It did not mention any IR procedure was done for lower extremity revascularization, and only the catheter was mentioned, so code where the catheter was stopped at.
 
And since there is no mention of the catheter placement, I would code 36200 for the catheter in the aorta and 75716 for bilateral lower extremity angio. If the dictation is changed to say where the catheter was placed, then either 36245 or 36246 could be used.
HTH,
Jim Pawloski, CIRCC
 
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