#### eeverett2

##### New

Hello all,

Recently a question came up in our office, and we are unable to come to a decision as to how a right SFA catheter placement via a contralateral left transfemoral approach should be coded. The only diagrams we are able to find are for a right transfemoral approach (see attached), so the question is if provider takes a left approach, would that diagram be mirrored?

For example, our provider attempted a right transfemoral approach, however due to some blockage, he opted to move to a left transfemoral approach. He then moved the guidewire over the aorta and catheterized the right SFA. So looking at the diagram from a right approach, an ipsilateral right SFA cath placement would be considered a first order 36245. However, because a contralateral left approach was taken, and the guidewire transcended the aorta into the opposite side, would this now be considered a third order 36247?

Any help is appreciated! Thanks in advance.

Recently a question came up in our office, and we are unable to come to a decision as to how a right SFA catheter placement via a contralateral left transfemoral approach should be coded. The only diagrams we are able to find are for a right transfemoral approach (see attached), so the question is if provider takes a left approach, would that diagram be mirrored?

For example, our provider attempted a right transfemoral approach, however due to some blockage, he opted to move to a left transfemoral approach. He then moved the guidewire over the aorta and catheterized the right SFA. So looking at the diagram from a right approach, an ipsilateral right SFA cath placement would be considered a first order 36245. However, because a contralateral left approach was taken, and the guidewire transcended the aorta into the opposite side, would this now be considered a third order 36247?

Any help is appreciated! Thanks in advance.

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