Hope someone has some ideas on this one. I am just stumped. Doctor did a cut down on the Rt CFA access the vessel stent the common iliac with two stents and the crossed over and placed a stent in the proxmial Lt common iliac, ran the dye again and noticed a flap in the distal common iliac, could not pass the wire any further. Then percutaneously stuck the Lt CFA and placed the stent in the distal Lt common iliac.
My question is I know that I can bill 37207 for the stents in the RT common iliac and 37208 for the stent in the proxmial Lt common iliac but can I bill 37205 for the percutaneous stent in the distal common iliac since it was a different access point or not because it was the same vessel>
Thanks
Lisa
That is quite a delima. I have a somewhat different thought process, see if it makes sense to you.
There are two vessels being stented, the RT and LT common iliacs. The initial access was a cutdown of the RT common femoral artery, second access was the LT common femoral
artery.
to me a "cutdown" does not necessarily equate to "open". Case in point is access for a AAA repair 34800-34825, all involve opening the femorals, iliacs and/or brachial, but are not "open" procedures. Open repairs of AAA are 34830, or 35082-35103.
Also, the definition of 37207-37208 from CDR " The physician makes an incision in the skin overlying
the vessel to be catheterized.
The vessel is dissected, and nicked with a small blade. A catheter with a stent-transporting tip is threaded into
the vessel. The catheter travels to the point where
the vessel needs additional support, and the compressed stent(s) is passed from the catheter into the vessel, where it expands to support the vessel walls...." at no point is the catheter advanced beyond
the opened vessel.
To me, this means a open stent procedure is when the catheter/stent is not advanced beyond the open vessel, in this case the RT common femoral. Since the catheter/stent was advanced beyond the open vessel, I would code it 37205/75960 for the initial vessel (RT common iliac) and 37206/75960 for the additional vessel (lt common iliac). There are certainly two catheters placed so I would add 36245 and 36140-59. Always code for the number of vessels treated/stented, not for the number of stents placed.
HTH
