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CPT for Femoral Artery Cutdown and Cannulation Only

coffee2day

Networker
Messages
62
Best answers
0
Hello, any advice on what code to use for a vascular surgeon who did Right femoral artery with femoral artery isolation and cannulation followed by right femoral artery primary repair, hand held ultrasound guidance identification of the femoral artery?

This was for a tavr procedure, I'm not sure if this was the same session as the TAVR procedure or a separate session, but my surgeon only did the cutdown portion of the procedure, no documentation of tavr surgery involvement, would CPT 34812 work?

"The patient is a high risk candidate for surgical aortic valve replacement and
therefore he was a much better candidate for TAVR at this point. With the
preoperative evaluation, we noted the patient's RV was severely tortuous and
therefore decided on a primary cutdown with identification and also isolation of
the right femoral artery.The patient was prepped and draped in the usual
sterile fashion for the TAVR procedure. After this was ready, we proceeded with
an ultrasound identification of the location of the right femoral artery.
Thereafter, incision was then made above the inguinal crease. The femoral
artery was then identified. Pursestring suture was placed over the left
preselected area on the femoral artery for cannulation. At the end of procedure
after the 24-French sheath was then removed the previously placed suture was
then initially tightened down. Vascular clamp was then placed proximally and
distally to the femoral artery. Thereafter, the pursestring suture was removed
and then the artery was then repaired primarily. After completion of the repair,
the distal femoral artery clamp was first removed followed by the proximal
femoral clamp. Hemostasis was noted. The cutdown was then reapproximated in 3
layer fashion."
 

msorrell1

New
Messages
5
Best answers
0
Did you have obtain an answer for your question? I am in need of advice.

Hello, any advice on what code to use for a vascular surgeon who did Right femoral artery with femoral artery isolation and cannulation followed by right femoral artery primary repair, hand held ultrasound guidance identification of the femoral artery?

This was for a tavr procedure, I'm not sure if this was the same session as the TAVR procedure or a separate session, but my surgeon only did the cutdown portion of the procedure, no documentation of tavr surgery involvement, would CPT 34812 work?

"The patient is a high risk candidate for surgical aortic valve replacement and
therefore he was a much better candidate for TAVR at this point. With the
preoperative evaluation, we noted the patient's RV was severely tortuous and
therefore decided on a primary cutdown with identification and also isolation of
the right femoral artery.The patient was prepped and draped in the usual
sterile fashion for the TAVR procedure. After this was ready, we proceeded with
an ultrasound identification of the location of the right femoral artery.
Thereafter, incision was then made above the inguinal crease. The femoral
artery was then identified. Pursestring suture was placed over the left
preselected area on the femoral artery for cannulation. At the end of procedure
after the 24-French sheath was then removed the previously placed suture was
then initially tightened down. Vascular clamp was then placed proximally and
distally to the femoral artery. Thereafter, the pursestring suture was removed
and then the artery was then repaired primarily. After completion of the repair,
the distal femoral artery clamp was first removed followed by the proximal
femoral clamp. Hemostasis was noted. The cutdown was then reapproximated in 3
layer fashion."
Did you ever receive an answer to your question? I am in need of advice on same question.
 

mk2001

Networker
Messages
39
Best answers
0
For a TAVR, a cardiologist and a cardiothoracic surgeon have to be present and both have to dictate. The TAVR codes have to be billed w/modifier 62.
The standard code is usually 33361 but for an open femoral artery approach it is 33362.
 
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