# Endovascular repair popliteal aneurysm



## elkecranfill (Dec 31, 2008)

I am fairly new to vascular surgery and do not have all the resources available at this time. Can anyone help me with the following scenario:

A small incision was made in the proximal thigh and dissection was cut down to the superficial femoral artery which was exposed only anteriorly. A testing suture of 5-0 Prolene was placed. The 18-gauge needle was introduced into the artery, and the Benson wire was advanced under fluoroscopy. A 5 French sheath was placed. 
Intraop angiogram was performed with ____ injections, and the aneurysm was identified and measured and marked. We elected to use a 7mmx15cm lenght stent. The 5 French sheath was excanged with an 8 French sheath. The Benson wire was exchanged with a stiff ___ wire. The stent was advanced over the wire and positioned properly with the graft extending about 2cm below the knee joint. The graft was deployed wihtout difficulty. The 7 mmx4cm Paraflex wire was then used, and the stent graft was dilated. Intraoperative angiogram was performed which showed excellent results with no residual stenosis, no extravasation or endoleak. The procedure was terminated.... 

It was originally coded out: 
34812-59 
37207 
75710 

34812 lists that the procedures are for AAA repairs. Since this is a different area/artery I was not sure if it would apply here. 

I see a code for direct repair for popliteal aneurysm - CPT 35151 but nothing for endovascular repair. This question was posed twice in the past 3 years on this list serve but no answers came forth. I would greatly appreciate some direction on this one. Thanks.


----------



## dpumford (Jan 3, 2009)

Hello!  I have ran into this same situation.

With using the 37207 *Open* stent placement you would not code the 34812, for this is used if iliac, abdominal or thoracic aortic stent graft is placed.

You can also code 795960-26 for the angio done after the stent placment.  There is also a  catheter placement code you should code. ie 36245-36247.

You can code the 75710-26 if not done for guidance.  This will need a mod 59 because of the 75960-26.

I would review and look at coding this 37207, 36245,75710-26-59, and 75960-26.

Depending on the dictation I have verify my coding with the physician.

Hopefully this helps!
DP


----------

