Wiki IVUS with revascularization??

Lynda Wetter

True Blue
Local Chapter Officer
Glen Allen, VA
Best answers
Would this be coded as 37227, 37250 & 75945 or just 37227? Is the intravascular ultrasound included in the endovascular revascularization? Therapeutic or diagnostic?

The groin was sterilely prepped and draped. The skin was anesthetized

with lidocaine. The right common femoral artery was entered. A

catheter was placed in the aorta. An aortogram was performed. The

catheter was positioned at the bifurcation. A pelvic arteriogram was


The contralateral common femoral artery was selectively catheterized.

A unilateral left leg runoff was performed.

From a catheter in the ipsilateral common femoral artery a unilateral

right leg runoff was performed.

Other procedures:

I. Intravascular ultrasound: Intravascular ultrasound of the left

common femoral artery and left superficial femoral artery was

performed. After atherectomy and stent placement additional SFA

intravascular ultrasound was performed.

2. Atherectomy: Atherectomy of the candy wrap are lesions involving

the left SFA stent and the in stented restenosis was treated with 4

passes of the EV 3 LX atherectomy device.

3. Stent placement: A 7 x 16 mm stent was deployed proximal to and

overlapping the mid SFA stent and postdilated with a 6 mm balloon.


Intravascular ultrasound:

Left SFA: There is 70% stenosis at the proximal and distal ends of the

previously placed SFA stent. There is diffuse and stent restenosis.

The proximal stenosis extends outside of the stent. Post atherectomy

there is significant debulking of the SFA. Residual narrowing in the

SFA proximal to the original stent was noted. This lesion was treated

with stent placement. Completion intravascular ultrasound shows good

Diagnostic IVUS is not included

Per Dr. Z's Interventional Radiology, "Do code for IVUS when performed for diagnostic purpose before, during, or after lower extremity endovascular revascularization. Check your LCD closely, as there may be limitations for the use of these codes."