Wiki Vascular Surgery - Help Needed

[dmjbear]

1) what code is assigned when a PTA is performed to macerate the clot. I emailed the physician and he stated the clot was due to underlying stenosis, but the angioplasty was for clot maceration in hopes of avoiding the possible complication from tpa. Would this be a thrombectomy or angioplasty?

2) When the patient has a pta for clot maceration and tpa on the same day are we able to code both the thrombectomy and tpa? Some of the QA and I found indicated the pta was bundled into the thrombolytic therapy.

Lower extremity location

 

[mk2001]

1) what code is assigned when a PTA is performed to macerate the clot. I emailed the physician and he stated the clot was due to underlying stenosis, but the angioplasty was for clot maceration in hopes of avoiding the possible complication from tpa. Would this be a thrombectomy or angioplasty?

2) When the patient has a pta for clot maceration and tpa on the same day are we able to code both the thrombectomy and tpa? Some of the QA and I found indicated the pta was bundled into the thrombolytic therapy.

Without knowing what area was being treated or seeing the report it's hard to tell but it sounds like angioplasty would be billed.
Mechanical thrombectomy includes thrombolytic injections during the procedure, but if the tpa catheter is left in after the surgery for continuous treatment then it can be billed separately.