# Need Coding Help!



## 634sg4fs65g4fg (May 20, 2010)

I am now coding for an additional dr. in our group who does more surgery than the rest. Can anyone tell me how to code Subclavian arterial bilateral? Also Catheter placement R renal vein, and Thrombectomy of R renal vein? Thank you!


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## dpeoples (May 21, 2010)

thomasgail said:


> I am now coding for an additional dr. in our group who does more surgery than the rest. Can anyone tell me how to code Subclavian arterial bilateral? Also Catheter placement R renal vein, and Thrombectomy of R renal vein? Thank you!



There are many questions that need to be answered before this one can.

They are:
"Subclavian arterial bilateral" what? Angiography? Catheter placement? both? Where was the initial access established? (femoral or brachial etc)

A catheter placement into the renal vein is usually first order, 36011, but could be higher depending on initial access.

A Renal Vein Percutaneous Thrombectomy is coded 37187. I doubt they are performed open but if so that would be an unlisted code.


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## 634sg4fs65g4fg (May 24, 2010)

Ok, here is one that I have the report: 
Abdominal aortagram
Left iliac percutaneous transluminal angioplasty
infrarenal abdominal aortic aneurysm endograft repair with contralateral limb placement
Help?


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## KeriH423 (Jun 9, 2010)

So much has to do with how the physician dictates the procedures and what they are actually doing...

Page 179 of CPT2010 Endovascular Repair of Abdominal Aortic Aneurysm is very well written concerning the guidelines for these procedures.  Without seeing the operative report it is difficult to figure the circumstances, but I can give a couple suggestions.  Endovascular repairs are billed in components based on the type of graft being used, exposure/approach, catheter placements and S&I.

The "abdominal aortogram" during an endo AAA repair is reported as 75952.  Secondly, it's highly unlikely that they are performing a "diagnostic" angiography unless this was an emergent repair, which I have only seen done in open sessions.

For the left iliac angioplasty, you need to determine if this was done in the "target zone" to promote outflow of the endograft placed, if so, it is not billable.  If it is the common iliac artery, this is usually the case.

Hope this helps!


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