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Iliac Stent

  1. #1
    Default Iliac Stent
    Medical Coding Books
    Can somone please help with this one?

    (37221,75625,36245,75710) ??


    Right iliac stenosis and claudications.


    PROCEDURE PERFORMED:

    1. Abdominal vascular flush angiogram.
    2. Right lower extremity runoff angiogram.
    3. PTA of the right iliac artery
    4. Stenting of the right iliac

    PROCEDURE:

    After the informed consent was obtained, the patient was brought to the cardiac catheterization laboratory,and prepped and draped in usual sterile fashion. The right femoral area was anesthetized with 10 mL of 0.5% Xylocaine. The right femoral artery was cannulated using a micropuncture set in modified Seldinger technique with a 6-French sheath. Right lower extremity runoff was performed. An angled tip glidewire was used to cross the iliac artery occlusion with the support of a glide catheter. The wire was then
    exchanged over to a supra core 035 guidewire and heparin 6000 units was administered intravenously. A Fox Cross PTA balloon 5 x 60 mm was used to predilate the lesion. The distal segment was then stented with a Cook Zilver 7 x 40 mm self expanding stent, and the proximal segment was then stented with a Cordis Smart control 7 x 40 mm self expanding stent. The stents were then post dilated with a Fox Cross 7 x 40 mm PTA balloon. Right lower extremity runoff angiogram was performed. The sheath was sutured in place and Plavix 600 mg was administered orally. The patient was then transferred to his room in stable condition. There were no complications.

    IMPRESSION:

    Successful PTA and stenting of the right common iliac artery

  2. #2
    Location
    Richardson, TX
    Posts
    822
    Default
    Quote Originally Posted by Worldwalker View Post
    Can somone please help with this one?

    (37221,75625,36245,75710) ??


    Right iliac stenosis and claudications.


    PROCEDURE PERFORMED:

    1. Abdominal vascular flush angiogram.
    2. Right lower extremity runoff angiogram.
    3. PTA of the right iliac artery
    4. Stenting of the right iliac

    PROCEDURE:

    After the informed consent was obtained, the patient was brought to the cardiac catheterization laboratory,and prepped and draped in usual sterile fashion. The right femoral area was anesthetized with 10 mL of 0.5% Xylocaine. The right femoral artery was cannulated using a micropuncture set in modified Seldinger technique with a 6-French sheath. Right lower extremity runoff was performed. An angled tip glidewire was used to cross the iliac artery occlusion with the support of a glide catheter. The wire was then
    exchanged over to a supra core 035 guidewire and heparin 6000 units was administered intravenously. A Fox Cross PTA balloon 5 x 60 mm was used to predilate the lesion. The distal segment was then stented with a Cook Zilver 7 x 40 mm self expanding stent, and the proximal segment was then stented with a Cordis Smart control 7 x 40 mm self expanding stent. The stents were then post dilated with a Fox Cross 7 x 40 mm PTA balloon. Right lower extremity runoff angiogram was performed. The sheath was sutured in place and Plavix 600 mg was administered orally. The patient was then transferred to his room in stable condition. There were no complications.

    IMPRESSION:

    Successful PTA and stenting of the right common iliac artery
    I would bill 37221 75710-59 But I don't see the abdominal angio, unless I'm over looking it?
    Julie Graham, BA, CPC, CCC

  3. Default
    Quote Originally Posted by jewlz0879 View Post
    I would bill 37221 75710-59 But I don't see the abdominal angio, unless I'm over looking it?

    Julie,
    I read this over. Nope, you are not overlooking anything here you are right on!
    Theresa CCS-P CPMA CCC ICDCT-CM

  4. #4
    Location
    Alexandria, LA
    Posts
    518
    Default
    Quote Originally Posted by Worldwalker View Post
    Can somone please help with this one?

    (37221,75625,36245,75710) ??


    Right iliac stenosis and claudications.


    PROCEDURE PERFORMED:

    1. Abdominal vascular flush angiogram.
    2. Right lower extremity runoff angiogram.
    3. PTA of the right iliac artery
    4. Stenting of the right iliac

    PROCEDURE:

    After the informed consent was obtained, the patient was brought to the cardiac catheterization laboratory,and prepped and draped in usual sterile fashion. The right femoral area was anesthetized with 10 mL of 0.5% Xylocaine. The right femoral artery was cannulated using a micropuncture set in modified Seldinger technique with a 6-French sheath. Right lower extremity runoff was performed. An angled tip glidewire was used to cross the iliac artery occlusion with the support of a glide catheter. The wire was then
    exchanged over to a supra core 035 guidewire and heparin 6000 units was administered intravenously. A Fox Cross PTA balloon 5 x 60 mm was used to predilate the lesion. The distal segment was then stented with a Cook Zilver 7 x 40 mm self expanding stent, and the proximal segment was then stented with a Cordis Smart control 7 x 40 mm self expanding stent. The stents were then post dilated with a Fox Cross 7 x 40 mm PTA balloon. Right lower extremity runoff angiogram was performed. The sheath was sutured in place and Plavix 600 mg was administered orally. The patient was then transferred to his room in stable condition. There were no complications.

    IMPRESSION:

    Successful PTA and stenting of the right common iliac artery
    If this is all of the report, I would only code 37221. I see no indication that a diagnostic study was done. He says "Right lower extremity runoff was performed" but he provides no findings, and no indication that this angiogram was used to make the decision to treat. I suspect he used a template for the procedure list and description and didn't delete what he didn't do (abdominal aortogram), or what was not diagnostic (extremity runoff).

  5. #5
    Default
    Thanks everyone.

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