I would have opened this thread thinking to myself "no brainer". Here's my dilemma.

Patient has a axillofemoral bypass. Access is through the left femoral artery. The catheter is advanced into the aorta, then innominate, then the axillary and into the graft. The catheter is then advanced through the graft, out of the distal anastomosis and into the popliteal artery. (Where did they find that length of catheter?)

So now the question is: 36217 or 36247 for selective catheter placement? The selection began off of a 36215-36217 branch but ended in a 36245-36247 branch.

Any advice would be greatly appreciated. I have been coding vascular interventions for 13 years and this is a first. If you have a reference in which you came by your decision I would like to know that as well. I can't find anything. Please drop me an email to pokirae1@yahoo.com.


Rae Smith, CPC, CCP