# Peripheral vascular coding question



## Heartcoder  (Aug 15, 2008)

Could someone code this scenario. 
Pt brought to cath lab. Right common femoral artery was used and a 5 French sheath inserted. First a Omni-flush catheter advanced into distal aorta and aortoiliam bifemoral angiogram performed. then a wire passed up and over into left superficial femoral artery and a glide catheter brought over into the artery and runoff from FFA down to feet performed. Iliac pictures taken on left with an Omni catheter and iliam pictures on right through a 5 French sheath. Right leg runoff taken through 5 French sheath. 

I have coded this, but could use an experieced coder's help.
thank you.
Kathy


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## MLS2 (Aug 16, 2008)

I'm thinking just a 75716 (bi-fem angio) and a 36247 (sfa selection)


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## feliciathomas (Aug 17, 2008)

I am not that experienced in radiology coding - however, I disagree with the previous person assumption of 75716. This code specifically states bi-lateral,and you plainly state that is was the right femoral artery that was used for this cath procedure.  I would venture to say that it should be coded with 75710.


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## lisammy (Aug 18, 2008)

I agree with Mindys except a 75625 would also be allowed because of the aortagram. No where does it say that the intention was a cath, just that the procedure was preformed in the cath lab


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## MLS2 (Aug 18, 2008)

so do you (lisammy) agree with the 36247 also or no?


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## stgregor (Aug 18, 2008)

*Right common femoral artery *was used and a 5 French sheath inserted. First a Omni-flush catheter advanced into distal aorta and an *aortoiliac bi-femoral angiogram *was performed (75625). Then a wire passed up and over into *left superficial femoral artery *and a glide catheter brought over into the artery (36247) and *runoff from SFA down to feet performed.* Iliac pictures taken on left with an Omni catheter and iliac pictures on right through a 5 French sheath. *Right leg runoff taken through 5 French sheath. * (75716)

36247 - Selective cath plcmt into left SFA from contralateral right approach
75625 - Abdominal aortogram
75716 - Bilateral lower extremity runoff

The initial "aortoiliac bifemoral angiogram" is encompassed in 75625. The left SFA is selected (36247) and runoff images of the left lower extremity are obtained. Then the catheter is pulled back and an injection/imaging of the right lower extremity is done through the sheath in the right common femoral artery. (75716) So, you have an abdominal aortography and a bilateral lower extremity runoff angiography with selective repositioning of the catheter into the left SFA.


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## MLS2 (Aug 19, 2008)

I agree


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