Wiki Peripheral intervention help

jmbarrera

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Can I please get some assistance with this procedure!!

Procedure performed
Aortogram and left femoral angiography and left popliteal angiography. Directional atherectomy of the left superficial femoral artery and angioplasty with a drug-coated balloon of the left superficial femoral artery.

Indication-
Peripheral vascular disease with claudication with failed medical therapy and occluded left superficial femoral artery by CT angio

Description of procedure-
After the appropriate consent was obtained, the patient was sedated with 2mg of Versed intravenously and 50 micrograms of fentanyl intravenously. Local Xylocaine was given in the right groin. A 7-french sheath was placed in the right femoral artery and then an aortogram was performed with and Omni flush catheter with the findings of mild atherosclerosis of the descending aorta and patent iliac arteries in both legs. Then the same catheter and an Advantage wire were used to pass into the left femoral artery with selective angiography showing an occlusion of the left superficial femoral artery. The lesion was crossed with the Advantage wire and a picture was taken of the left popliteal artery selectively with the findings of 3-vessel patency below the knee. Then a spider wire was used instead of the Advantage wire and atherectomy was performed with 3 passes with significant removal of the plaque from the left superficial artery. Then a balloon angioplasty was performed with a 6 x 120 drug-coated balloon with excellent results with a residual of 10%. Another angiography of the left femoral artery was performed selectively and then another angiography of the popliteal artery was performed selectively showing that he 3 vessel where patent below the left knee; the peroneal, the anterior tibial and the posterior tibial. There where no complications. the patient tolerated the procedure well

I have
37225
75625-26
75716-26-59
75774-26-59

Thank you in advance
 
Last edited:
Can I please get some assistance with this procedure!!

Procedure performed
Aortogram and left femoral angiography and left popliteal angiography. Directional atherectomy of the left superficial femoral artery and angioplasty with a drug-coated balloon of the left superficial femoral artery.

Indication-
Peripheral vascular disease with claudication with failed medical therapy and occluded left superficial femoral artery by CT angio

Description of procedure-
After the appropriate consent was obtained, the patient was sedated with 2mg of Versed intravenously and 50 micrograms of fentanyl intravenously. Local Xylocaine was given in the right groin. A 7-french sheath was placed in the right femoral artery and then an aortogram was performed with and Omni flush catheter with the findings of mild atherosclerosis of the descending aorta and patent iliac arteries in both legs. Then the same catheter and an Advantage wire were used to pass into the left femoral artery with selective angiography showing an occlusion of the left superficial femoral artery. The lesion was crossed with the Advantage wire and a picture was taken of the left popliteal artery selectively with the findings of 3-vessel patency below the knee. Then a spider wire was used instead of the Advantage wire and atherectomy was performed with 3 passes with significant removal of the plaque from the left superficial artery. Then a balloon angioplasty was performed with a 6 x 120 drug-coated balloon with excellent results with a residual of 10%. Another angiography of the left femoral artery was performed selectively and then another angiography of the popliteal artery was performed selectively showing that he 3 vessel where patent below the left knee; the peroneal, the anterior tibial and the posterior tibial. There where no complications. the patient tolerated the procedure well

I have
37225
75625-26
75716-26-59
75774-26-59

Thank you in advance

37225 for atherectomy is correct., 75625, I would not code because the renals or visceral arteries have not been described. Placing the catheter is the distal aorta does not count for an abdominal aortogram. For the extremities, I would only code 75710-LT as the distal arteries of the rt leg are not reported. As for 75774, that is a guiding shot and is not billable.
HTH,
Jim Pawloski, CIRCC
 
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