Wiki stent placement of the celiac artery

[amym]

Is it appropriate to code this as 37205 and 36245 or can I bill for any diagnostics?

PX: Abdominal aortogram with selective celiac arterial angiogram. PTCA of the celiac artery and stent placement of the celiac artery.

After informed consent was obtained, the patient was brought into the cardiology suite and the patient was prepped according to sterile precautions. Access was obtained in
the right common femoral artery using a 7-French sheath. After this, an 0.035 guidewire was passed and over this is a 5-French Omniflush catheter was passed and an abdominal aortogram was performed, which revealed 80% ostial celiac artery stenosis. After that, a JR-4 catheter was brought next to the ostial lesion and selective celiac angiogram was performed. Then a 0.014 BMW 300 cm wire was passed and parked in the distal vessel. The rest of the intervention was carried throughout with guidance on this wire. The lesion was initially dilated by a 6/20 balloon. After the initial dilatation, there was suboptimal results noted with the angioplasty in the region and a general stent with a balloon expandable 6 x 17 bare metal stent. This was followed by post dilatation

 

[fzamarripa01]

Coding for Vascular Procedure

yes you can use those two codes and always remember you can code all your radiology codes for anything between the carotids and the legs. Hope this helps

 

[Jim Pawloski]

Is it appropriate to code this as 37205 and 36245 or can I bill for any diagnostics?

PX: Abdominal aortogram with selective celiac arterial angiogram. PTCA of the celiac artery and stent placement of the celiac artery.

After informed consent was obtained, the patient was brought into the cardiology suite and the patient was prepped according to sterile precautions. Access was obtained in
the right common femoral artery using a 7-French sheath. After this, an 0.035 guidewire was passed and over this is a 5-French Omniflush catheter was passed and an abdominal aortogram was performed, which revealed 80% ostial celiac artery stenosis. After that, a JR-4 catheter was brought next to the ostial lesion and selective celiac angiogram was performed. Then a 0.014 BMW 300 cm wire was passed and parked in the distal vessel. The rest of the intervention was carried throughout with guidance on this wire. The lesion was initially dilated by a 6/20 balloon. After the initial dilatation, there was suboptimal results noted with the angioplasty in the region and a general stent with a balloon expandable 6 x 17 bare metal stent. This was followed by post dilatation

Unless there was a diagnostic procedure done before the intervention, you can bill for the diagnostic and intervention. So if there is no previous diagnostic exam, you have 36245, 75726, 37205, 75960. I didn't bill the PTA because the doctor didn't state the amount of stenosis post PTA to be considered "failed". Next yaer, the angioplasty is included in the stent placement.
HTH,
Jim Pawloski, CIRCC