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Lower Extremity stenting w/perfusion TPA catheter

  1. #1
    Default Lower Extremity stenting w/perfusion TPA catheter
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    Need help with the following procedure... This is a new one to me and i'm afraid i am missing something...

    Day 1 Procedure: We did an abdominal aortogram, left iliac angiogram,
    right iliac angiogram, run off of the left lower extremity. We
    placed a catheter in the right iliac, right external iliac and
    left external iliac arteries. Also we did left common femoral
    artery stenting, left external iliac stenting, left common iliac
    stenting. We also did a left iliac AngioJet and also did a left
    iliac SFA perfusion TPA catheter. We did a right external iliac

    Day 2: We did Left iliac angiogram w/ runoff- still has total occlusion after 48 hours TPA infusion

    Day 3: Another Left iliac angiogram w/runoff- starting to see some flow, continue for another 24 hours...

    So far for this Day 1 procedure I have:

    Would Day 2 and 3 just be the 36246 and 7571026??

  2. #2
    Alexandria, LA
    Without seeing a report, I'm only guessing based on what you've written, but it seems like you have
    37226 - left CFA stent
    37221- left external iliac stent
    37221-59 - right external iliac stent
    37223 - left common iliac stent
    37184 or 37186 for the angiojet thrombectomy (primary or secondary)
    37201-59, 75896-59 for initiation of thrombolysis

    75716-59 for bilateral lower extremity angiogram (if documented as diagnostic), possibly 75774 also, depending on actual procedure.
    75625-59 for abdominal aortogram.
    (these 2 could be 75630 instead, again, depending on actual procedure done.

    The revascularization codes above depend on the lesions being separate lesions and not bridging lesions covered by 1 stent. Revascularization codes also include catheterization, so 36247 would not be separately coded.

    Day 2 and Day 3 are 75898
    (code also 37209, 75900 if the thrombolysis catheter is replaced (not if same catheter is taken out for the angiogram and then put back in, but a new catheter put in.

  3. #3
    Thank you so much and for the explanation of each! Helps A LOT!!!

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