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Cpt 37227-Can I bill anything

  1. #1
    Question Cpt 37227-Can I bill anything
    Medical Coding Books
    Can I bill anything else other than 37227?

    PROCEDURE PERFORMED:
    1. Antegrade arterial stick to the left common femoral artery.
    2. Laser atherectomy followed by balloon percutaneous transluminal
    angioplasty to the distal superficial femoral artery/popliteal artery
    chronic total occlusion.
    3. Percutaneous transluminal angioplasty to mid superficial femoral
    artery.
    4. Placement of stent to the common femoral artery at the level of the
    groin with IDEV stent.

    INDICATION: The patient is presenting with gangrene to the left fifth
    toe and also severe ischemic changes of the left foot. Finding of
    severe occlusive disease with total occlusion of the superficial femoral
    artery in the distal third and going into the popliteal and high grade
    stenosis in the mid superficial femoral artery and high grade stenosis
    of the common femoral artery with significantly reduced inflow and
    revascularization is recommended.

    PROTOCOL: After the patient was identified, the patient was brought to
    the endovascular lab. This is a very lengthy and long procedure and
    required multiple levels of procedural sedation. At this point first an
    antegrade 7 French stick was performed to the left common femoral artery
    and then subsequently guidewire was advanced into the superficial
    femoral artery. At this point a Storq catheter was used to exchange the
    wire. After the Storq wire was advanced and crossed the lesion distally
    in the lower third and then at this point was exchanged with an 0.014
    wire upon which a 2.0 laser fiber was advanced and multiple passes were
    made of the chronic occlusion. Improvement was noted and subsequently
    followed by a 4 x 80 Admiral balloon with excellent results with full
    restoration of flow noted in this segment.

    Attention was directed to the mid superficial femoral artery. The same
    4 x 80 Admiral balloon was then used to dilate in the mid segment with
    marked improvement and therefore it was felt not to be necessary to
    stent it. Subsequently, the same balloon was pulled back into the
    common femoral artery in the area of a very complex and calcified high
    grade stenosis of the superficial femoral artery was treated with a
    balloon inflation first. Subsequently, IDEV 5 x 60 stent was then
    delivered at this area with full coverage with excellent placement.
    Following this a 6 x 40 balloon was used, which post dilate excellent
    end results were noted with marked improvement and the entire flow was
    pictured and excellent three vessel runoff was noted to the foot.

  2. #2
    Default
    Quote Originally Posted by amym View Post
    Can I bill anything else other than 37227?

    PROCEDURE PERFORMED:
    1. Antegrade arterial stick to the left common femoral artery.
    2. Laser atherectomy followed by balloon percutaneous transluminal
    angioplasty to the distal superficial femoral artery/popliteal artery
    chronic total occlusion.
    3. Percutaneous transluminal angioplasty to mid superficial femoral
    artery.
    4. Placement of stent to the common femoral artery at the level of the
    groin with IDEV stent.

    INDICATION: The patient is presenting with gangrene to the left fifth
    toe and also severe ischemic changes of the left foot. Finding of
    severe occlusive disease with total occlusion of the superficial femoral
    artery in the distal third and going into the popliteal and high grade
    stenosis in the mid superficial femoral artery and high grade stenosis
    of the common femoral artery with significantly reduced inflow and
    revascularization is recommended.

    PROTOCOL: After the patient was identified, the patient was brought to
    the endovascular lab. This is a very lengthy and long procedure and
    required multiple levels of procedural sedation. At this point first an
    antegrade 7 French stick was performed to the left common femoral artery
    and then subsequently guidewire was advanced into the superficial
    femoral artery. At this point a Storq catheter was used to exchange the
    wire. After the Storq wire was advanced and crossed the lesion distally
    in the lower third and then at this point was exchanged with an 0.014
    wire upon which a 2.0 laser fiber was advanced and multiple passes were
    made of the chronic occlusion. Improvement was noted and subsequently
    followed by a 4 x 80 Admiral balloon with excellent results with full
    restoration of flow noted in this segment.

    Attention was directed to the mid superficial femoral artery. The same
    4 x 80 Admiral balloon was then used to dilate in the mid segment with
    marked improvement and therefore it was felt not to be necessary to
    stent it. Subsequently, the same balloon was pulled back into the
    common femoral artery in the area of a very complex and calcified high
    grade stenosis of the superficial femoral artery was treated with a
    balloon inflation first. Subsequently, IDEV 5 x 60 stent was then
    delivered at this area with full coverage with excellent placement.
    Following this a 6 x 40 balloon was used, which post dilate excellent
    end results were noted with marked improvement and the entire flow was
    pictured and excellent three vessel runoff was noted to the foot.
    Since there wasn't an diagnostic angio performed, that is all you can bill.
    Thanks,
    Jim Pawloski, CIRCC

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