# cardio vasc surg



## pdrgos (Oct 18, 2010)

Please help with coding this procedure...Selective right superficial femoral artery angiogram, sel rt popliteal angio, sel rt anterior tibial angio, sel rt peroneal angio, successful percutaneous angioplasty of rt anterior tibial, successful rt percutaneous angioplasty of  rt peroneal. Contralateral approach. Thanks! Pam


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## Jim Pawloski (Oct 18, 2010)

pdrgos said:


> Please help with coding this procedure...Selective right superficial femoral artery angiogram, sel rt popliteal angio, sel rt anterior tibial angio, sel rt peroneal angio, successful percutaneous angioplasty of rt anterior tibial, successful rt percutaneous angioplasty of  rt peroneal. Contralateral approach. Thanks! Pam



I would need some more information to be able to bill all of the selcetives, but with this info., I would this;
1. 36247 for the rt anterior tibial
2. 36248 for the rt peroneal
3. 75710 for the rt leg angio
4. 35470/75962 for the PTA anterior tibial
5. 35470/75964 for the PTA peroneal

HTH,
Jim Pawloski, CIRCC


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## pdrgos (Oct 19, 2010)

Thanks Jim.  Op notes are as follows...left groin prepped...a 4-french sheath was inserted in the left femoral artery. we then used a rim catheter to place a glidewire in the right SFA. We then exchanged over a  Glide catheter for a magic torgue wire. We then placed a 65-cm destination sheath from the left femoral artery into the right superficial femoral artery. We then obtained angiograms, and then proceeded to the intervention as outlined below.
 ANGIOGRAM: The right mid to distal SFA had mild atherosclerosis. The right popliteal artery had mild to mod disease. THe anterior tibial had severe disease in is ostium and proximal portion, following which was 100% occluded. Though the peroneal had re-stenosis , the posterior tibial arter was 100% occluded. At the ankle there appears to be a run-off from the peroneal artery and a reconstituted anterior tibia. The posterior tibial was very faintly reconstituted. 
Does the op notes change your original coding? Thanks for your help! Pam


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## Jim Pawloski (Oct 19, 2010)

pdrgos said:


> Thanks Jim.  Op notes are as follows...left groin prepped...a 4-french sheath was inserted in the left femoral artery. we then used a rim catheter to place a glidewire in the right SFA. We then exchanged over a  Glide catheter for a magic torgue wire. We then placed a 65-cm destination sheath from the left femoral artery into the right superficial femoral artery. We then obtained angiograms, and then proceeded to the intervention as outlined below.
> ANGIOGRAM: The right mid to distal SFA had mild atherosclerosis. The right popliteal artery had mild to mod disease. THe anterior tibial had severe disease in is ostium and proximal portion, following which was 100% occluded. Though the peroneal had re-stenosis , the posterior tibial arter was 100% occluded. At the ankle there appears to be a run-off from the peroneal artery and a reconstituted anterior tibia. The posterior tibial was very faintly reconstituted.
> Does the op notes change your original coding? Thanks for your help! Pam



Not really Pam.  I was thinking of using 75774 for additional runs, but I feel that they were guiding shots for the PTA which is not billable.


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