Wiki Attempted Carotid Stent Placement

[Jim Pawloski]

I have a case, where the procedure was ordered as a carotid stent placement. Bilateral Cervicocercical arteriograms (36223-50) were performed along with a 3-d angiogram. The doctor tried to cross the stenosis using multiple wires and wires and microcatheters. Despite prolong measures and and a significant amount of time, the doctor could not cross the lesion. The case was finished.
My question is would you code 37215-74 for the attempted stent placement, or just the angioplasty?

Thanks,
Jim Pawloski, CIRCC

 

[mk2001]

I have always just billed the catheter/angio code since the stent was never used and there are codes available for what was actually able to be performed.

 

[Jim Pawloski]

Thanks for your response.
Jim

 

[arclayton]

Hi Jim,

I found this hint on the RadRX website:
Unsuccessful Revascularization or Unacceptable Outcome. If a revascularization is unsuccessful because the lesion cannot be crossed, then the appropriate access and/or selection and imaging only should be coded. On the other hand, if the lesion is crossed and the revascularization is performed but with an unacceptable outcome, then the revascularization is coded since all the work of the revascularization was done. If the revascularization has been initiated and it is discontinued, assign the revascularization codes with the appropriate modifiers (‐53, ‐73, ‐74).

Amy Clayton, CCS, CIRCC