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37224 - extremity imaging

  1. #1
    Question 37224 - extremity imaging
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    Is CPT 37224 the only code I can bill here?

    PROCEDURES PERFORMED:
    1. Selective lower extremity imaging.
    2. Percutaneous transluminal angioplasty of the left superficial femoral
    artery/popliteal arteries.

    CLINICAL SUMMARY: The patient has presented with severe claudication in
    both legs. He underwent right superficial femoral artery percutaneous
    transluminal angioplasty with marked improvement in his claudication
    symptoms and healing of the ulcer on the right leg. He now comes in for
    percutaneous transluminal angioplasty of the left superficial femoral
    artery, which is 95% occluded.

    PROTOCOL: Due to sharp angulation of the bifurcation of the aorta,
    antegrade stick was preferred, which was performed however due to scar
    tissue there was some difficulty in advancing the sheath and therefore
    an Amplatz stiff straight wire was then advanced over a dilator and
    subsequently a 7-French sheath was placed with the intention of possibly
    using stenting. The lesion was identified as a 95% focal stenosis in
    the superficial femoral artery/popliteal junction and there was a
    secondary lesion, which was in the popliteal artery right at the knee
    joint, which was at least 70% in severity. Once the balloon inflation
    was performed using 5 x 40 balloon, marked improvement was noted
    in this lesion with less than 30% residual narrowing with margins and no
    evidence of dissection and good flow was noted.

    The second lesion in the popliteal artery was also dilated using the
    same 5 x 40 balloon with some improvement with no dissection. At this
    point, distal flow was also imaged with the pictures of the trifurcation
    taken in magnification, which reveals that the posterior tibial artery
    has a 90% stenosis and two-vessel runoff is present in the foot.

    FINDINGS: Successful percutaneous transluminal angioplasty of the left
    superficial femoral artery/popliteal arteries with 5 x 40 balloon with
    stenosis reduction from 95% to less than 30%.

  2. #2
    Location
    Birmingham, Alabama
    Posts
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    Quote Originally Posted by amym View Post
    Is CPT 37224 the only code I can bill here?

    PROCEDURES PERFORMED:
    1. Selective lower extremity imaging.
    2. Percutaneous transluminal angioplasty of the left superficial femoral
    artery/popliteal arteries.

    CLINICAL SUMMARY: The patient has presented with severe claudication in
    both legs. He underwent right superficial femoral artery percutaneous
    transluminal angioplasty with marked improvement in his claudication
    symptoms and healing of the ulcer on the right leg. He now comes in for
    percutaneous transluminal angioplasty of the left superficial femoral
    artery, which is 95% occluded.

    PROTOCOL: Due to sharp angulation of the bifurcation of the aorta,
    antegrade stick was preferred, which was performed however due to scar
    tissue there was some difficulty in advancing the sheath and therefore
    an Amplatz stiff straight wire was then advanced over a dilator and
    subsequently a 7-French sheath was placed with the intention of possibly
    using stenting. The lesion was identified as a 95% focal stenosis in
    the superficial femoral artery/popliteal junction and there was a
    secondary lesion, which was in the popliteal artery right at the knee
    joint, which was at least 70% in severity. Once the balloon inflation
    was performed using 5 x 40 balloon, marked improvement was noted
    in this lesion with less than 30% residual narrowing with margins and no
    evidence of dissection and good flow was noted.

    The second lesion in the popliteal artery was also dilated using the
    same 5 x 40 balloon with some improvement with no dissection. At this
    point, distal flow was also imaged with the pictures of the trifurcation
    taken in magnification, which reveals that the posterior tibial artery
    has a 90% stenosis and two-vessel runoff is present in the foot.

    FINDINGS: Successful percutaneous transluminal angioplasty of the left
    superficial femoral artery/popliteal arteries with 5 x 40 balloon with
    stenosis reduction from 95% to less than 30%.
    Yes. from CPT " A single interventional code is used no matter what combination of angioplasty/stent/arthrectomy is applied to all segments, including the common, deep, and superficial femoral arteries as well as the popliteal artery"....

    HTH
    Danny L. Peoples
    CIRCC,CPC

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