# Venous Atherectomy?



## ablythe (Dec 4, 2014)

Is there a current CPT code for a venous atherectomy?  My physician performed an atherectomy in the common iliac vein.

Thanks,

Allison
CPC, CCC


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## Jim Pawloski (Dec 5, 2014)

ablythe said:


> Is there a current CPT code for a venous atherectomy?  My physician performed an atherectomy in the common iliac vein.
> 
> Thanks,
> 
> ...



Hi Allison,
Do you have an operative report for the procedure?  I have not heard of an atherectomy in the venous system.
Thanks,
Jim Pawloski, CIRCC


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## ablythe (Dec 10, 2014)

Hi Jim,

I had not heard of it being done in the venous system either.  The operative report says, in part, "The previously placed 6F sheath was exchanged for a 8F introducer.  A Spartacore wire was placed in the IVC.  Atherectomy was performed in the common femoral to common iliac veins with use of a Turbohawk atherectomy device.  Repeat IVUS imaging was performed after atherectomy.  The lesion in the native common femoral vein extending into the common femoral vein stent was treated with a 6.0x100mm Lutonix drug coated stent.  We then performed serial PTA of the common femoral, external iliac and common iliac veins with 10mmx40mm, 12mmx40mm and 14mmx40mm Dorado ballons and Vida ballons.  IVUS imaging was repeated after PTA with manual pullback.  Final venography showed excellent result with no severe stenosis but significant residual ISR.  There was notable recoil at the lesion in the native common femoral vein although the severity of the stenosis had decreased from 80% to 40%." 

Thanks again for looking at this.

Allison, CPC, CCC


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## Jim Pawloski (Dec 10, 2014)

ablythe said:


> Hi Jim,
> 
> I had not heard of it being done in the venous system either.  The operative report says, in part, "The previously placed 6F sheath was exchanged for a 8F introducer.  A Spartacore wire was placed in the IVC.  Atherectomy was performed in the common femoral to common iliac veins with use of a Turbohawk atherectomy device.  Repeat IVUS imaging was performed after atherectomy.  The lesion in the native common femoral vein extending into the common femoral vein stent was treated with a 6.0x100mm Lutonix drug coated stent.  We then performed serial PTA of the common femoral, external iliac and common iliac veins with 10mmx40mm, 12mmx40mm and 14mmx40mm Dorado ballons and Vida ballons.  IVUS imaging was repeated after PTA with manual pullback.  Final venography showed excellent result with no severe stenosis but significant residual ISR.  There was notable recoil at the lesion in the native common femoral vein although the severity of the stenosis had decreased from 80% to 40%."
> 
> ...



Hi Allison,
I just found in Dr. Z's book taht there are no codes for venous atherectomy.  He says to use unlisted vascular code 37799 for that.
HTH,
Jim


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## ablythe (Dec 12, 2014)

*Venous Atherectomy*

Hi Jim,

That is what I was thinking.  Thank you SO much for looking into this for me.

Allison


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