# Injection of TPA



## MADDIE (Sep 14, 2012)

Would appreciate any input for the following: patient has a stenosis of a right popliteal interposition graft which the doc angioplasties. On completion angiogram he notices a thrombus in the peroneal artery and advances a glide catheter into this vessel and injects TPA. This is separate from the the popliteal graft and further down the leg. His approach for the interventions was from the left femoral artery and the interventions were done on the right side. My question is can I code for the catheter placement in the peroneal artery or is this considered bundled into the 37224 code.
Thanks in advance for any help


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## Jim Pawloski (Sep 14, 2012)

MADDIE said:


> Would appreciate any input for the following: patient has a stenosis of a right popliteal interposition graft which the doc angioplasties. On completion angiogram he notices a thrombus in the peroneal artery and advances a glide catheter into this vessel and injects TPA. This is separate from the the popliteal graft and further down the leg. His approach for the interventions was from the left femoral artery and the interventions were done on the right side. My question is can I code for the catheter placement in the peroneal artery or is this considered bundled into the 37224 code.
> Thanks in advance for any help



IMO, the TPA injection is part of the intervention, because TPA was not infused for more than an hour.  So the thrombolysis code is not applicable here.  So all you have is the 37224, and any diagnostic imaging that was done before the procedure.

HTH,
Jim Pawloski, CIRCC


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## MADDIE (Sep 17, 2012)

Thanks Jim, that's what I thought.


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