Wiki Right SFA cath placement via left transfemoral approach

eeverett2

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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.
 

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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.
Yes it would be mirrored so 36247 is correct. Approach (36140), aorta (36200), common iliac (36245), cath could go into either the external or internal so that makes both of them (36246), cath could then go into either the profunda or SFA so that makes them 36247.

Hope this helps!
 
Last edited:
Yes it would be mirrored so 36247 is correct. Approach (36140), aorta (36200), common iliac (36245), cath could go into either the external or internal so that makes both of them (36246), cath could then go into either the profunda or SFA so that makes them 36247.

Hope this helps!
Sorry for the delay! Thank you so much for your response Margaret, it's much appreciated!
 
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