# Popliteal Stenting



## Pillow1 (Dec 1, 2009)

This is a big favor.. 

If anyone has the time to share their expertise I would be very appreciative.  I was advised how to code this two entirely different ways including  
codes that don't appear to match the lower extremities.
Also the dx: popliteal anuerism (442.3) is not included in the Cardio/Vascular/Thoracic Coding Companion in some of the CPT codes for example 34805 does not allow 442.3.

This is what I came up with: 
36245-59LT
36246-LT
34812-LT
34813-LT
35151-LT (would like to use 34805 to describe the stent but it =abdominal)
35474-LT51
75962-26
75710-26(FOLLOW UP ANGIOGRAPHY)

"CARDIAC CATHETERIZATION"  

PROCEDURE:                                                                    
Left SFA/popliteal angiogram and left popliteal stenting with                 
endovascular Viabahn covered stent.                                           

PREOPERATIVE DIAGNOSIS:                                                       
Left popliteal aneurysm.                                                      

POSTOPERATIVE DIAGNOSIS:                                                      
Left popliteal aneurysm.                                                      

DESCRIPTION OF PROCEDURE:                                                     
The patient was prepped and draped in the usual sterile fashion.              
After adequate local anesthesia with 2% Xylocaine, the left femoral           
artery was cannulated with a 4-French sheath.  Next, a 6-French               
sheath was exchanged and a Perclose device was then deployed, after        
which, it was exchanged for a 9-French sheath, and then angiogram was       
performed of the left SFA into the popliteal/trifurcation region.             
There appeared to be a large left popliteal aneurysm noted.  It was           
then covered with a 9 x 150 Viabahn endovascular covered stent.  It           
was then post angioplasties with a 10 mm x ______ mm balloon at both         
the distal and proximal tips.  Follow-up angiography showed                   
well-deployed stent.  The aneurysm had now resolved.  It was well             
covered at its origin and at the distal anastomosis site.  No                 
endovascular leak was noted.  After which, the Perclose was used to           
close the common femoral artery with an excellent result.  No                 
complications were noted.                                                     

IMPRESSION:                                                                   
1.     Left popliteal aneurysm.                                               
2.     Successful stenting with a Viabahn endovascular covered                
stent which was 9 x 150, which successfully covered the entire                
aneurysmal segment.                                                           
3.     Final angiogram showed well-apposed stent struts with no               
endovascular leak and excellent/normal flow.                                  
4.     Successfully Perclosed at the termination of the procedure             
without any complications.         

THANK YOU
DENISE   (studying for the CPC and CCC / CCVTC exams)


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