Help! New to Cardiothoracic


Big Stone Gap
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I have an op note that I am in desperate need of help with. The procedures performed were:
1. Abdominal Aortogram with runoff exams bilaterally.
2. Corssing of an occluded left superficial femoral artery with balloon dilation and then stenting x2 of the left superficial femoral artery.

Operative Procedure:
WIth the patinet supine on the cardiac cath table, the right groin was prepped with antiseptic solution and draped. An 18 gauge needle was used to puncture the right common femoral artery. A Glidewire was passed up into the abdominal aorta and then a Contra catheter was passed over the guidewire and an aortogram was done with runoffs of the left leg. The Contra catheter was then seated into the origin of the left common iliac artery and a guidewire was passed down into the profunda femoris artery. A crossover sheath was placed and then a stiff Glidewire was used to cross the superficial femoral artery, eventually into the popliteal and down into the posterior tibial artery. The stenoses were then balloon dilated and then that entrie portion of the distal 3rd of the SFA was stented with self expanding stents. Post stenting, the stents were balloon dilated and then repeat angiogram was performed which showed normalization of the superficial femoral artery. The sheath was then withdrawn into the abdominal aorta and replaced with a short 7 French sheath. A completion arteriogram of the right side was performed through the sheath. The sheath was then removed with Mynx device and the patient was taken back to his room.

One co-worker said the abdominal aortogram is coded as 36140 and 36200 and the balloon dilation and stenting is 37226. Something just doesn't seem right about this. HELP!

I need help with this, please !:confused:


True Blue
Richardson, TX
Best answers
I don't see where he did bilateral runoffs but I think you could bill:


You can't bill 36140 for puncture to right common fem nor would you bill cath placement in the aorta (in the case presented). 37226 includes all cath placements and S&I related to procedure or intervention (75625/75710 - read pg. 373 in AMA CPT 2012 and it will explain). That is why you need the 59 modifier's on the S&I codes.