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fem-pop code 35474

  1. #1
    Question fem-pop code 35474
    Medical Coding Books
    I am looking for a source that provides Medicare's stance on using 35474
    for lesions in both the femoral and the popliteal artery. I found a CPT Assist
    that instructs to use 1x per vessel fem AND pop if lesions are treated. But
    I cannot find MC documentation stating their position on this. I have searched IOMs,NCCI policy, WPS MC LCD does not appear to address. Can
    anyone direct me to an official source? Thanks!

  2. Default fem-pop code 35474
    I just recently found an article on the CMS website. If you go to the Medicare Coverage Database there is a box where you can type in a document ID. Type in A43095 for the article ID and it should bring up an article which specifically refers to PTA of the femoral and popliteal arteries. The effective date for this article is 1/1/2007. Looks like Medicare is stating to only charge 35474 once per limb even if separate lesions are treated in the femoral and the popliteal arteries. This does seem to be at odds with what the AMA states in the August 2006 CPT Assist.

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