# Code for subclavian artery angioplasty and stenting



## drhoads (Oct 18, 2012)

Please help code op-report:  Left subclavian artery engioplasty and stenting.

Description of procedure:  Access was obtained through right common femoral artery using fluoroscopic guidance.  Wire was placed up through the right iliac system into the aorta.  We placed a 7-French 70 cm sheath all the way up into the thoracic aorta.  We then used a Bern catheter and a glidewire t select he left subclavian artery.  4000 units of intravenous heparin were give prior to angioplasty and stenting and 2 gm of Ancef were infused prior to stenting.  The stenosis was visualized and crossed.  We then exchanged wires for a Rosen wire.  The sheath would not advance across the stenosis.  We then placed a 9x2 balloon to postdilate this in multiple areas.  A completion angiogram showed excellent results.  The wires, catheters and sheaths were removed and 8-French Angioseal was placed in the groin and good hemostasis was obtained. 

Any help in coding this report would be greatly appreciated.

Thank you!


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## jewlz0879 (Oct 24, 2012)

LT Subclavian - 36215/75710-26
PTA - 35475/75962-26
Stent - 37205/75960-26

HTH


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## drhoads (Oct 25, 2012)

Thank you so much. I am new at coding for CVS and I find it very confusing.  You have been a big help


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## dpeoples (Oct 25, 2012)

drhoads said:


> Please help code op-report:  Left subclavian artery engioplasty and stenting.
> 
> Description of procedure:  Access was obtained through right common femoral artery using fluoroscopic guidance.  Wire was placed up through the right iliac system into the aorta.  We placed a 7-French 70 cm sheath all the way up into the thoracic aorta.  We then used a Bern catheter and a glidewire t select he left subclavian artery.  4000 units of intravenous heparin were give prior to angioplasty and stenting and 2 gm of Ancef were infused prior to stenting.  The stenosis was visualized and crossed.  We then exchanged wires for a Rosen wire.  The sheath would not advance across the stenosis.  We then placed a 9x2 balloon to postdilate this in multiple areas.  A completion angiogram showed excellent results.  The wires, catheters and sheaths were removed and 8-French Angioseal was placed in the groin and good hemostasis was obtained.
> 
> ...



I usually agree with Julie but not for this case. All that I would code is:
37205/75960 for the stent placement and
36215 for the catheter placement into the left subclavian artery.
I would not bill for angiography because I do not see a diagnostic exam and interpretation.
I would also not bill for angioplasty because I do not think the documentation supports a primary angioplasty attempt that was insufficient, and lead to subsequent stent placement. This seems to be pre-and post dilation. 

Clear as mud right? 

HTH


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