Wiki Still need help coding this femoral injury


Sioux City, IA
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Need some help finding the correct CPT codes


We had a patient that came in with a PFA (profundus femoral artery) injury which required stenting. I chose 37799 and added a note stating that a Niabahn covered stent was placed due to injury to PFA. I am questioning if that is correct? I dont feel that 37226 is appropriate because this is not treatment due to occlusive disese. I am also question what codes I should use for the angio that was done after selective catheterization of the internal iliac artery. Here is a short descriptor of the procedure and the codes I selected. Any feedback is greatly appreciated!

Procedure details:
A 6 French 10 cm sheath was placed into the left CFA percutaneously. Catheters were exchanged over a guidewire. A 6 French IM catheter was used to cross over from the left common iliac to the right common iliac artery at the terminal aortic bifurcation. An Advantage Guidewire was advanced into the right superficial femoral artery. The IM catheter was removed and replaced by a 6 French MPA2 catheter for diagnostic angiography. Selective angiography was performed with catheter placement and injections in the right common iliac artery, with susequent repositioning of the catheter for select placement and injections in the right internal iliac artery, external iliac artery, and common femoral artery. The site of puncture and bleeding was identified in the right profundus femoral artery. The MPA2 catheter was removed. The 6 French sheath was removed and replaced by a 7 French Terumo Destination 45 cm sheath. The sheath tip was advanced to the right CFA for endovascular therapy.

The punctured PFA was treated with a Viabahn covered stent, with post deployment dilation of the stent and an excellent result.

The codes I selected are:
37799-RT-Viabahn stent placement for repair of puncture PFA-profundus femoral artery
75774-26 x's 3
75716-26 bilateral lower extremity angio

Again any feedback is much appreciated! Thanks in advance
Hi Robin. I'm not sure why you are not using the 37226 as the CPT descriptor for 37226 has stated, "angioplasty when performed" not an absolute that it had to be done to report. Also, 37226 (as well as the other 372xxx codes) are not just for patient's with occlusive disease (refer to CPT Assistant, Dec. 2011, pg.15).

Hope this helps.
Thank you for the information and the CPT assist reference. I didnt go with the 37226 because of some information I had found on prior posts here in the forum regarding femoral artery injuries and stent placements and also with the note in CPT regarding "use for patients with occlusive disease." I will look at the CPT assist and make sure to note that for future coding. Thank you again.