ttglasscock
Contributor
FINDINGS OF DIAGNOSTIC AORTOGRAM/ARTERIOGRAM: Normal Great arch anatomy, moderate to severe stenosis orifice of the Left CCA successfully treated with 8x27mm BE PTA/Stent w/o embolic protection, Severe short segment LICA stenosis. Normal vertebral arteries Bilaterally, Minimal RICA stenosis, Mild proximal inominate artery stenosis. Normal Intracranial carotid circulation with brisk cross-filling Right to Left. Pt. would benefit from Left CEA. My office will schedule.
EXAM: Arch Aortogram, Aoritic catheterization, Selective RCCA catheterization, Selective LCCA catheterization Bil. Cervical carotid arteriography, Bil. Cerebral Carotid arteriography. Left Common carotid artery angioplasty and stent placement without EPD
PROCEDURE: After informed consent was obtained the Right groin was prepped in a sterile fashion and the right Common Femoral artery was accessed using a micro-puncture set. A 5Fr Pigtail catheter was placed in the aortic arch and arch aortogram performed. A 5Fr Simmons 2 catheter was reformed in the subclavian artery and placed in the Right CCA artery and Rt. Cervical and cerebral angiography was performed.. The catheter was then reformed and the L CCA was selected and similar images were obtained. 5,000 units of heparin was given and a 6F pinnacle destination sheath was placed in the transverse aortic arch. The Simmons 2 catheter and GW were used to cross the orificial CCA stenosis, The sheath was placed in the CCA and a PTA with an 8mm balloon was performed followed by placement of a BE 8mm x 27mm stent. F/U arteriogram revealed a widely patent Left CCA. Once all images were reviewed by me and found to be adequate, the catheter, wires and sheaths were removed, 5,000 units of protamine was given and a Proglide closure device was used. There were no complications.
I coded as 36223-RT & 37216-LT. But then I found out that 37216 is not covered by Medicare. Is there another code I can use for percutaneous cervical carotid stent placement?
EXAM: Arch Aortogram, Aoritic catheterization, Selective RCCA catheterization, Selective LCCA catheterization Bil. Cervical carotid arteriography, Bil. Cerebral Carotid arteriography. Left Common carotid artery angioplasty and stent placement without EPD
PROCEDURE: After informed consent was obtained the Right groin was prepped in a sterile fashion and the right Common Femoral artery was accessed using a micro-puncture set. A 5Fr Pigtail catheter was placed in the aortic arch and arch aortogram performed. A 5Fr Simmons 2 catheter was reformed in the subclavian artery and placed in the Right CCA artery and Rt. Cervical and cerebral angiography was performed.. The catheter was then reformed and the L CCA was selected and similar images were obtained. 5,000 units of heparin was given and a 6F pinnacle destination sheath was placed in the transverse aortic arch. The Simmons 2 catheter and GW were used to cross the orificial CCA stenosis, The sheath was placed in the CCA and a PTA with an 8mm balloon was performed followed by placement of a BE 8mm x 27mm stent. F/U arteriogram revealed a widely patent Left CCA. Once all images were reviewed by me and found to be adequate, the catheter, wires and sheaths were removed, 5,000 units of protamine was given and a Proglide closure device was used. There were no complications.
I coded as 36223-RT & 37216-LT. But then I found out that 37216 is not covered by Medicare. Is there another code I can use for percutaneous cervical carotid stent placement?