Wiki Attempt at rt popliteal access


Fort Worth, TX
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I'd appreciate another set of eyes and opinions here. In this case, I don't think there is anything that I can charge. The patient had a previous angiogram last month.

Indications: A 58-year-old diabetic smoker with bilateral SFA occlusions. She has a small caliber but patent popliteal artery that reconstitutes after an occluded right SFA. The SFA was occluded flush at the level of the profunda, and I felt that a retrograde popliteal access would increase our chances of revascularizing her SFA percutaneously on the right side.

We tried to access the right popliteal artery using multiple attempts. We used SonoSite ultrasound to locate the popliteal vein and artery on the right side. Despite multiple attempts, I was never able to cannulate the right popliteal artery and get retrograde access.

The caliber of the popliteal is fairly small and it is fairly heavily calcified. After about 60 minutes of attempt I stopped and returned the patient back to the holding area. There were no issues with hemostasis.

Thanks for any information offered!

I believe you are correct, I do not see a possible surgical procedure in here that could be billed. However, if the patient is an outpatient status, possibly you could bill for prolonged services. Take a look at codes 99354-99357. Just a thought, not positive you can bill this, but it's worth a look! ;)