# B/L fem access for B/L stents



## bportcardio (Apr 17, 2012)

It is my udnerstanding you can not bill for secondary femoral access, is this correct still?

scenerio:  physician did b/l kissing illiac stents and used b/l femorial access to do the procedure.


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## jmcpolin (Apr 17, 2012)

if you have separate punctures to reach the aorta on both sides you would bill 36200 and 36200-59, or 50 or RT LT whichever your carrier prefers.


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## Jim Pawloski (Apr 18, 2012)

bportcardio said:


> It is my udnerstanding you can not bill for secondary femoral access, is this correct still?
> 
> scenerio:  physician did b/l kissing illiac stents and used b/l femorial access to do the procedure.



Another way to bill is if the second access does not go to the aorta, then you can have 36200, 36140-59.  In your case of bilateral Iliac stent Placement, you need 37221, 37221-59.  This includes access and imaging, if a true diagnostic arteriogram was not performed.

HTH,
Jim Pawloski, CIRCC


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## donnajrichmond (Apr 18, 2012)

bportcardio said:


> It is my udnerstanding you can not bill for secondary femoral access, is this correct still?
> 
> scenerio:  physician did b/l kissing illiac stents and used b/l femorial access to do the procedure.



Prior to 2011 if the doctor placed bilateral iliac stents from bilateral access you would have been able to code for 2 catheterizations.  Each access is coded separtely. 

Since 1/1/2011 you no longer code the catheterization separately.  Bilateral iliac stents would be 37221 coded twice (37221, 37221-59; or 37221-50; or 37221-LT and 37221-RT depending on payer preference.)


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## jmcpolin (Apr 18, 2012)

Oh my gosh I did not even think about the stent placements I am getting rusty on my interventionals since I don't do them anymore


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## theresa.dix@tennova.com (Apr 19, 2012)

jmcpolin said:


> Oh my gosh I did not even think about the stent placements I am getting rusty on my interventionals since I don't do them anymore



Yes my thoughts were why would you bill for the access ? especially if your doing stents.


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