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cardiac cath.w.bilat.comm.iliac IVUS's

  1. #1
    Default cardiac cath.w.bilat.comm.iliac IVUS's
    Medical Coding Books
    here is the situation--insertion site is rt.fem.artery--a rt.and lt.heart cath.was done first--

    The 6 F JR4 catheter was pulled back into
    the abdominal aorta and a hand injection of Isovue 370 was performed
    to evaluate the common iliac arteries.
    Common iliac artery IVUS
    Due to evidence of iliac calcification and stenosis on CT, it was decided to further
    evaluate the iliac arteries with intravenous ultrasound (IVUS)
    imaging. A weight-based bolus dose of unfractionated heparin was
    administered to achieve an ACT of >200 sec, and maintained above 200
    sec for the duration of the IVUS procedure. The patient received a
    total heparin dose of 4,500 units. A 6F JR4 diagnostic catheter was
    used to advance the 0.035 J-wire into the left common iliac artery.
    The catheter was removed and a 6F IMA guide catheter was advanced into
    the left common iliac artery. A 0.014 Prowater Flex coronary
    guidewire was advanced into the distal left common iliac artery.
    After its position was confirmed by contrast injection, an ultrasound
    imaging catheter was passed over the Prowater Flex wire into the
    distal vessel. Image recording was initiated and iliac artery
    ultrasound images were acquired during 0.5 mm per second pullback.
    IVUS evaluation revealed a left common iliac artery with minimal
    luminal diameter of 40mm. The IMA guide catheter was pulled back into
    the distal right common iliac artery, and the Prowater Flex wire was
    advanced to the proximal right common iliac artery. After its
    position was confirmed by contrast injection, an ultrasound imaging
    catheter was passed over the Prowater Flex wire into the proximal
    vessel. Image recording was initiated and iliac artery ultrasound
    images were acquired during 0.5 mm per second pullback. IVUS
    evaluation revealed a right common iliac artery with minimal luminal
    diameter of 40mm.

    rt.and lt. cath.w.graft angio-93461

    75716
    37250
    75945
    37251
    75946

    can I bill 36245 for contralat.cath. to lt.comm.iliac if cath.was done for IVUS and not a selective angio or intervention?

    Thanks.

  2. #2
    Location
    San Antonio
    Posts
    15
    Default
    Yes catheter placement 36245-59 LT is appropriate to code.

  3. #3
    Default
    thank you! no matter how many times you code it seems something always comes up that throws you.

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