CPCCODERII
Guest
We had a patient that came in with a PFA (profundus femoral artery) injury which required stenting. I chose 37799 and added a note stating that a Niabahn covered stent was placed due to injury to PFA. I am questioning if that is correct? I dont feel that 37226 is appropriate because this is not treatment due to occlusive disese. I am also question what codes I should use for the angio that was done after selective catheterization of the internal iliac artery. Here is a short descriptor of the procedure and the codes I selected. Any feedback is greatly appreciated!
Procedure details:A 6 French 10 cm sheath was placed into the left CFA percutaneously. Catheters were exchanged over a guidewire. A 6 French IM catheter was used to cross over from the left common iliac to the right common iliac artery at the terminal aortic bifurcation. An Advantage Guidewire was advanced into the right superficial femoral artery. The IM catheter was removed and replaced by a 6 French MPA2 catheter for diagnostic angiography. Selective angiography was performed with catheter placement and injections in the right common iliac artery, with susequent repositioning of the catheter for select placement and injections in the right internal iliac artery, external iliac artery, and common femoral artery. The site of puncture and bleeding was identified in the right profundus femoral artery. The MPA2 catheter was removed. The 6 French sheath was removed and replaced by a 7 French Terumo Destination 45 cm sheath. The sheath tip was advanced to the right CFA for endovascular therapy.
The punctured PFA was treated with a Viabahn covered stent, with post deployment dilation of the stent and an excellent result.
The codes I selected are:
36246-RT
37799-RT-Viabahn stent placement for repair of puncture PFA-profundus femoral artery
75774-26 x's 3
75716-26 bilateral lower extremity angio
Again any feedback is much appreciated! Thanks in advance
Procedure details:A 6 French 10 cm sheath was placed into the left CFA percutaneously. Catheters were exchanged over a guidewire. A 6 French IM catheter was used to cross over from the left common iliac to the right common iliac artery at the terminal aortic bifurcation. An Advantage Guidewire was advanced into the right superficial femoral artery. The IM catheter was removed and replaced by a 6 French MPA2 catheter for diagnostic angiography. Selective angiography was performed with catheter placement and injections in the right common iliac artery, with susequent repositioning of the catheter for select placement and injections in the right internal iliac artery, external iliac artery, and common femoral artery. The site of puncture and bleeding was identified in the right profundus femoral artery. The MPA2 catheter was removed. The 6 French sheath was removed and replaced by a 7 French Terumo Destination 45 cm sheath. The sheath tip was advanced to the right CFA for endovascular therapy.
The punctured PFA was treated with a Viabahn covered stent, with post deployment dilation of the stent and an excellent result.
The codes I selected are:
36246-RT
37799-RT-Viabahn stent placement for repair of puncture PFA-profundus femoral artery
75774-26 x's 3
75716-26 bilateral lower extremity angio
Again any feedback is much appreciated! Thanks in advance