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Wiki Vascular Surgery Anyone???

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KDGBNG

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Hello. I have an OP report I have been struggling with. If anyone else does vascular and could help, I would sure appreciate it!
The patient had a previous fem-pop bypass graft, saphenous vein. This vein segment is occluded. First the vein was accessed, and arteriogram was done. "outflow was thru the anterior tibial vein and I was able to pass a wire into this" .... and a stent was deployed. The balloon became disconnected to the stent, so the stent was deployed where it was and a second stent was ATTEMPTED. The graft was opened more distally, the stent removed and the arteriotomy closed with a patch graft. Another arteriogram was performed revealing satisfactory flow. All wounds closed...
Thats the basics.
I haven't a clue what to code.... Any help, again, is appreciated. Thanks. Karla
 
I would code one stent 37207 because it was an open stent, cath placement 36140 because he never changed from the original vessel. then depending on the findings to which S&I codes to use. based on the info provided that is the advise I can give
 
Slg

Karla,
I would bill for the catheterization, (based on the approach), and where the catheter tip was placed, the arteriogram if it was the "inital" and 1 stent. (This sounds like a balloon expandable stent.) So If one stent deployed and remained, and the other removed, I would bill only one stent.
 
I would still only bill for the catheterization, any initial S&I from that Catheterization, and 1 stent. Even if both stents were to have stayed in the vessel. This is a situation where I would need to see the op note to give specific codes for these procedures.
 
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