# PTA/stent of  L. SFA etc



## decus1956 (Mar 29, 2013)

Another one for you....  I have asked fellow coders in town, but they still havent responded...

Doc inteserted sheath in R. CFA.  Following this cath was advanced in to  mid AA, then cath was used to engage L. Common iliac and advanced into position in L. SFA, then popliteal and tibioperoneal trunk.  Following this sheath was advanced into LCFA and tip of sheath was positioned inside LSFA, making it 3rd order proc, selective arteriogram was performed of LSFA w/segmental runoffs.   A ruler was positioned adjacent to femur and following assessment, the decision was made to balloon LSFA, following this the decision was made to implant stents in the LSFA.  Leaving stork wire in place, a stent was positioned in distal portion of lesion, 2nd was overlapped w/first one and brought back into proximal LSFA.  Once lesion was covered balloon angioplasty was again performed, following this angiography was repeated with no complications.  There was a 3 vessel runoff to L. foot w/full expansion of stented segments and no evidence of dissections.  Following this, a sheath was brought back into LCIA and selective arteriogram of LCIA was performed.  Decision was made to leave alone.  

codes I think:
36247 LSFA
36245 LCIA
75710-26
37226 SFA pta/stent


----------



## reen828 (Mar 29, 2013)

*Pta/stent*

Hi,
36245 is bundled into the 36247 unless it was contralateral,but as he/she is just drawing the cath back to that order it is not coded, that being said it is bundled into the PTA/Stent, you can try a 59 also with the 75610-26, & 75774-26 for the additional run in the LCIA for decision to do surgery but may have to be appealed with notes, depending on any previous studies and insurance company.



deannegreen said:


> Another one for you....  I have asked fellow coders in town, but they still havent responded...
> 
> Doc inteserted sheath in R. CFA.  Following this cath was advanced in to  mid AA, then cath was used to engage L. Common iliac and advanced into position in L. SFA, then popliteal and tibioperoneal trunk.  Following this sheath was advanced into LCFA and tip of sheath was positioned inside LSFA, making it 3rd order proc, selective arteriogram was performed of LSFA w/segmental runoffs.   A ruler was positioned adjacent to femur and following assessment, the decision was made to balloon LSFA, following this the decision was made to implant stents in the LSFA.  Leaving stork wire in place, a stent was positioned in distal portion of lesion, 2nd was overlapped w/first one and brought back into proximal LSFA.  Once lesion was covered balloon angioplasty was again performed, following this angiography was repeated with no complications.  There was a 3 vessel runoff to L. foot w/full expansion of stented segments and no evidence of dissections.  Following this, a sheath was brought back into LCIA and selective arteriogram of LCIA was performed.  Decision was made to leave alone.
> 
> ...


----------



## decus1956 (Apr 1, 2013)

Thanks for your help!


----------

