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Wiki Billing of attempted atherectomy?

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kvo

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I am coding the following procedure where the physician attempted an atherectomy but was only able to place the device. According to the guidelines I have seen an attempted revascularization should be coded for the catheterization and imaging only yet a rep for the atherectomy device is stating this should be billed....What do you think?
Following is the main portion of the procedure report:

...Using a glidewire, the catheter was advanced into the right external iliac artery. Images of the right groin were obtained. Attempts to enter the right SFA were unsuccessful using a variety of wires and catheters. A Crosser atherectomy device was then inserted following placement of a support catheter. Contrast was injected which showed extravasation adjacent to the tip of the support catheter. A 8x4 angioplasty balloon was inserted and inflated x 2 across the dissection/ extravasation which controlled the bleeding. The balloon was removed and a bare metal stent, 8 x 6 was then placed over the dissection.
 
kvo said:
I am coding the following procedure where the physician attempted an atherectomy but was only able to place the device. According to the guidelines I have seen an attempted revascularization should be coded for the catheterization and imaging only yet a rep for the atherectomy device is stating this should be billed....What do you think?
Following is the main portion of the procedure report:

...Using a glidewire, the catheter was advanced into the right external iliac artery. Images of the right groin were obtained. Attempts to enter the right SFA were unsuccessful using a variety of wires and catheters. A Crosser atherectomy device was then inserted following placement of a support catheter. Contrast was injected which showed extravasation adjacent to the tip of the support catheter. A 8x4 angioplasty balloon was inserted and inflated x 2 across the dissection/ extravasation which controlled the bleeding. The balloon was removed and a bare metal stent, 8 x 6 was then placed over the dissection.
Click to expand...

I assign codes based on documentation, I would be reluctant to code as recommended by a device representative, they have a known bias (to sell more of their product).

Based on this portion of a report, I would not code an attempted atherectomy... I would code for a stent placement (which includes angioplasty). I am just not sure which vessel is involved, nor where the intial access was performed.

HTH :)
 
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