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



## mabar1571 (Feb 16, 2012)

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.


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## brownrm (Feb 20, 2012)

Yes catheter placement 36245-59 LT is appropriate to code.


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## mabar1571 (Feb 23, 2012)

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


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