BI Iliac Stents

Glenda52

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Please help!!! Not sure if I coded this correctly.

-Abdominal aortography with distall runoff
-Bilateral common femoral artery cannulation and angiography with distal runoff
-Bilateral common iliac artery angiography with angioplasty/stent using 2 covered stents.

this ia a 73-year-old lady who has claudication of her right leg. She had doppler of lower extremities by dr.-------. THis patient has monophasic blood flow in the right femoral artery___________claudation is there, therefore a diagnostic abdominal aortography was attempted.

after obtaining consent, a 6-French introducer sheat was placed in the left common femoral artery. we used a 6-French pigtail catheter and over a wholey wire, placed it in the suprarenal area. abdomoinal aortography in a straight AP view in the suprarenal area was done with distal runoff.

we then brouth the 6-french pigtail catheter out and brought a 5-french diagnositc catheter , this catheter was placed from the left side over the ostium of the right common iliac artery where there was 100% stump.. Tried to pass wire through but it was difficult. therefore i weny and placed a 6-french introducer sheath in the right common femoral artery. we performed angiogryaph of it. we then went on and used a .035 glidewire and crossed the lesion with no difficulties. we then went on a performed angioplasty with a peripheral balloon. this resulted of snowplowing of atheroma into the left common iliac area. we then went on a used a 6-french endhole catheter and tried to aspirate either thrombus or atheroma of the left common iliac artery. this was no help. repeat angiography in the infrarenal abdominal area revealed still presence of that plaque that was snowplowed to the left side.. no choice but to stent bilateral illiac arteries.. i then went on and aspirated both sheaths, exchanged it for a short shealth over a wire. i then went on and brought ---------atrium stent for the right side and a --------atrium stent for the left side. both were deployed simultaneaously. whe have excellent angiographic results. No residual stenosis. patient bilateray hypogastric arteries.

We then went on and injected through both sheaths in the common femoral arteries bilaterally and performed distal runoff. the patient has normal profunda, normal SFA and noraml popliteal artery with trifurcation of both vessels below the knee being normal.

I coded it
37221
37223
75630-59
75716-59

Is this correct or do i need to add 36246 and 36247?
 

dpeoples

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889
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Birmingham, Alabama
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Please help!!! Not sure if I coded this correctly.

-Abdominal aortography with distall runoff
-Bilateral common femoral artery cannulation and angiography with distal runoff
-Bilateral common iliac artery angiography with angioplasty/stent using 2 covered stents.

this ia a 73-year-old lady who has claudication of her right leg. She had doppler of lower extremities by dr.-------. THis patient has monophasic blood flow in the right femoral artery___________claudation is there, therefore a diagnostic abdominal aortography was attempted.

after obtaining consent, a 6-French introducer sheat was placed in the left common femoral artery. we used a 6-French pigtail catheter and over a wholey wire, placed it in the suprarenal area. abdomoinal aortography in a straight AP view in the suprarenal area was done with distal runoff.

we then brouth the 6-french pigtail catheter out and brought a 5-french diagnositc catheter , this catheter was placed from the left side over the ostium of the right common iliac artery where there was 100% stump.. Tried to pass wire through but it was difficult. therefore i weny and placed a 6-french introducer sheath in the right common femoral artery. we performed angiogryaph of it. we then went on and used a .035 glidewire and crossed the lesion with no difficulties. we then went on a performed angioplasty with a peripheral balloon. this resulted of snowplowing of atheroma into the left common iliac area. we then went on a used a 6-french endhole catheter and tried to aspirate either thrombus or atheroma of the left common iliac artery. this was no help. repeat angiography in the infrarenal abdominal area revealed still presence of that plaque that was snowplowed to the left side.. no choice but to stent bilateral illiac arteries.. i then went on and aspirated both sheaths, exchanged it for a short shealth over a wire. i then went on and brought ---------atrium stent for the right side and a --------atrium stent for the left side. both were deployed simultaneaously. whe have excellent angiographic results. No residual stenosis. patient bilateray hypogastric arteries.

We then went on and injected through both sheaths in the common femoral arteries bilaterally and performed distal runoff. the patient has normal profunda, normal SFA and noraml popliteal artery with trifurcation of both vessels below the knee being normal.

I coded it
37221
37223
75630-59
75716-59

Is this correct or do i need to add 36246 and 36247?
I don't clearly see a "pre-intervention" interpretation of images so I would be reluctant to code for "diagnostic" aortography or lower extremity angiography (75625/75630/75716).

For the stent placements, I suggest 37221 (x2) because this is a bilateral procedure. 37223 is for additional ipsilateral stents which is not the case here. You will need to modify according to your payor preference, some use 50, others RT/LT etc.

Do not code for catheter placement, that is included with the stent placements.

HTH :)
 
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