CPT code 36140

Messages
16
Location
Bentonville, AR
Best answers
0
Hello, I have pasted my Dr.'s report below. He goes to three different access sites to try and perform a heart cath. Pt has severe PVD and he was unable to perform the heart cath. Please let me know if I coded this correctly. My codes are below the report.
Thank you!!!


Procedure attempted: The plan was to perform emergent coronary angiography, LHC, left ventriculography and PCI if indicated and
feasible.
Procedures performed:
1. Right iliac angiogram.
2. Left iliac angiogram.
3. Right subclavian angiogram

Procedure description:
1. Right Common femoral vein access obtained, 5Fr sheath vascular advanced.
2. Right common femoral artery was cannulated, and due to difficulty in advancing the guidewire , an angiogram was performed with
a hand injection of IV contrast, and the procedure was stopped due to total occlusion of the common right iliac artery.
3. Left common femoral artery was cannulated, and due to difficulty in advancing the guidewire, an angiogram was performed with a
hand injection of IV contrast, and the procedure was stopped due to total occlusion of the common left iliac artery.
4. Right brachial artery was cannulated, but due to difficulty in advancing the guidewire , an angiogram was performed with a hand
injection of IV contrast, and the procedure was stopped due to total occlusion of right subclavian artery.
Procedure findings:
1. Severe Peripheral Arterial Disease, with total occlusion of both common iliac arteries and right subclavian artery.
2. The coronary angiogram and LHC could not be performed due to the reasons exposed above.


36140 (Rt com fem artery cath placement)
36140,59 (Lt com fem artery cath placement)
36140,59 (Right brachial artery cath placement)
75716,26 (bilateral low extrem)
75710,26,59 (Unilateral upper extrem. I didn't use the 75774,26 since he didn't select an artery)

Thanks again,
Kim Floyd,CPC
 

dpeoples

True Blue
Messages
889
Location
Birmingham, Alabama
Best answers
0
Hello, I have pasted my Dr.'s report below. He goes to three different access sites to try and perform a heart cath. Pt has severe PVD and he was unable to perform the heart cath. Please let me know if I coded this correctly. My codes are below the report.
Thank you!!!


Procedure attempted: The plan was to perform emergent coronary angiography, LHC, left ventriculography and PCI if indicated and
feasible.
Procedures performed:
1. Right iliac angiogram.
2. Left iliac angiogram.
3. Right subclavian angiogram

Procedure description:
1. Right Common femoral vein access obtained, 5Fr sheath vascular advanced.
2. Right common femoral artery was cannulated, and due to difficulty in advancing the guidewire , an angiogram was performed with
a hand injection of IV contrast, and the procedure was stopped due to total occlusion of the common right iliac artery.
3. Left common femoral artery was cannulated, and due to difficulty in advancing the guidewire, an angiogram was performed with a
hand injection of IV contrast, and the procedure was stopped due to total occlusion of the common left iliac artery.
4. Right brachial artery was cannulated, but due to difficulty in advancing the guidewire , an angiogram was performed with a hand
injection of IV contrast, and the procedure was stopped due to total occlusion of right subclavian artery.
Procedure findings:
1. Severe Peripheral Arterial Disease, with total occlusion of both common iliac arteries and right subclavian artery.
2. The coronary angiogram and LHC could not be performed due to the reasons exposed above.


36140 (Rt com fem artery cath placement)
36140,59 (Lt com fem artery cath placement)
36140,59 (Right brachial artery cath placement)
75716,26 (bilateral low extrem)
75710,26,59 (Unilateral upper extrem. I didn't use the 75774,26 since he didn't select an artery)

Thanks again,
Kim Floyd,CPC
Your codes look ok with one exception. I would use 36120 for the brachial artery access unless it was placed antegrade. The modifiers might depend upon the payor's preference. (76 instead of 59 for the catheter placements).

HTH :)
 
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