# Lower Extremity FFR?  HELP  :)



## Robbin109 (Aug 21, 2013)

Is this considered a lower extremity FFR?

"Because of the equivocal nature of the lesion appearing to be severe, it was felt prior to intervention that may jeopardize the large and bifurcating pr0funda on the left side, pullback gradients would be measured in order to ascertain hemodynamic significance of these angiographically abnormal segments.  Therefore, using NO14 wires through the catheter positioned distally into the SFA, we were able to do pullback mesurements with the maximum gradient across the area of stenosis at the origin of the left SFA measuring at about 15 mmHG to 20 MMHg. The rest of the pullback again measured left and 15 mm of trans-stenotic gradients."


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## Jim Pawloski (Aug 21, 2013)

Robbin109 said:


> Is this considered a lower extremity FFR?
> 
> "Because of the equivocal nature of the lesion appearing to be severe, it was felt prior to intervention that may jeopardize the large and bifurcating pr0funda on the left side, pullback gradients would be measured in order to ascertain hemodynamic significance of these angiographically abnormal segments.  Therefore, using NO14 wires through the catheter positioned distally into the SFA, we were able to do pullback mesurements with the maximum gradient across the area of stenosis at the origin of the left SFA measuring at about 15 mmHG to 20 MMHg. The rest of the pullback again measured left and 15 mm of trans-stenotic gradients."



Bundled into procedure.
Thanks,
Jim Pawloski, CIRCC


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## Robbin109 (Aug 23, 2013)

JIM,

So this isn't an FFR? What exactly are they doing? I see this from time to time and have not been coding it, but this MD wrote "pressure measurments across L and R iliofemorals" as it he wants he coded.

I've tried to look info up on this but can't seem to find anything.

Thanks for your help!


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## dpeoples (Aug 23, 2013)

Robbin109 said:


> JIM,
> 
> So this isn't an FFR? What exactly are they doing? I see this from time to time and have not been coding it, but this MD wrote "pressure measurments across L and R iliofemorals" as it he wants he coded.
> 
> ...



I know I am not Jim, however...
The code for FFR in the coronary arteries is 93571 and 93572 ( both are add on codes that can not be billed alone) but there is no code for FFR in any other vessels. 

HTH


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## Robbin109 (Aug 23, 2013)

Danny,

Thanks I have previously done research and it is suggested to bill FFR non-coronary with either 76496 or 37799, however, I'm not sure if that is what is actually being done here?

Is it?

Thanks!!!!!!!


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## dpeoples (Aug 23, 2013)

Robbin109 said:


> Danny,
> 
> Thanks I have previously done research and it is suggested to bill FFR non-coronary with either 76496 or 37799, however, I'm not sure if that is what is actually being done here?
> 
> ...



I don't think so, can you provide a report as an example?


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## Robbin109 (Aug 23, 2013)

I would have to retype the whole thing. The part at the top is the only relevant portion though.


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## dpeoples (Aug 23, 2013)

Robbin109 said:


> I would have to retype the whole thing. The part at the top is the only relevant portion though.



I hope the physician did something else, because all I see documented (that is code-able/bill-able) is a catheter placement, and I can't code that accurately without knowing the access site.

No code for FFR (pressure wire assessment).

HTH


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## Robbin109 (Aug 23, 2013)

Yes, there is much more to the report...this is the only  portion that mentions pressure measurments.


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