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Cpt 37227

  1. Default Cpt 37227
    Medical Coding Books
    Can we code for the catheterization(36247)if laser atherectomy of popliteal artery is done, along with 37227?
    Prabha CPC

  2. #2
    NCCI edits state that you can code both together with a -59 modifier on the 36247. This means the physician has to clearly document the separate and identifiable service on that date. Without an OP note for reference, I really cannot give you any advice as to what to code. I can however, tell you the NCCI edit is -59.

    Hope this helps
    Amy Pritchett,
    2017-2018 Secretary of Local Mobile AAPC Chapter
    2015-2016 President of Local Mobile AAPC Chapter

  3. Default
    This is the op report.Please help me out with the codes?

    Pre-op diag ? ischemic lower extremity with non healing left heel ulcer
    Findings: The entire lower extremity was occluded including previously placed stents as well as the above knee popliteal artery with good three vessel proximal part.
    Procedure in detail:
    Using a 21 gauge ministick needle right common femoral artery was cannulated.A mini sheath was placed through a guidewire and angiogram was performed of the right lower extremity.A j wire was placed in the distal aorta and using a 5 fench pigtail catheter was reformed in the distal aorta and bilateral lower extremity runoff was performed.This showed 40-50 percent stenosis of both common femoral arteries.It was decided to intervene on the left superficial femoral lesion.The pigtail catheter was exchanged for a UF catheter and was passed in to the left deep femoral artery at the level of the knee.The glidewire was exchanged for a super core wire.The short 5 french sheath was exchanged for a 6 french cook ansel sheath.Angiogram had shown the origin of the left superficial artery was very medial instead in the usual proximal location and was a very small approx 2-3 mm in diameter.Using a 0.035 angled catheter as well as the glide catheter,I was finally able to cannulate late and this was fairly difficult to do.After this I was able to pass a glidewire as well as a guide cathter down but just in to the mid superficial femoral artery.The patient does switch over to a Quick cross cathter as well as stiff 0.035 angled glidewire and was able to pass this down in to below knee popliteal artery.Angiogram was confirmed and I was in the true lumenof the below knee popliteal artery.Quick cross catheter wass passed over was exchanged for a 0.014 wire.A 0.9mm spectaetics laser cathter was then caliberated and laser googles were placed on the patient.Laser atheterctomy was then performed in the left superficial femoral artery and above knee popliteal artery.First forward pass with a fluency of 60 and frequency of 40 and both forward pass and backward pass at a fequecy of 80.Completion angiogram showed the channelhas now been created with flow distally.PTA was then performed beginning of above knee popliteal artery as well as the entire superficial femoral artery.Repeat angioplasty was performed.A 6mm*100mm absolute pro stent was deployed in the left proximal SFA.
    Prabha CPC

  4. Default
    artherectomy cpt code 37227 include selective cathetherization of artery hence not need to code it separately also there is bilateral extremity angiogram is performing with diagnostic finding my final codes will be 37227,75716-26,59

  5. Default
    Thanks for the input.
    Prabha CPC

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