# Popliteal Atherectomy



## amym (Nov 21, 2013)

Is it appropriate to code this as 37225? CTA Done within 30 days of the procedure and diagnostic portion not billed.  Can I bill anything else?

DESCRIPTION OF PROCEDURE:  After informed consent was obtained, 
patient was brought to the endoscopy suite and access was obtained 
in the right common femoral artery, with a 5-French sheath.  After 
access was obtained, a 0.035 wire was passed in the distal aorta, 
and a 5-French Omniflush catheter was advanced on the wire and 
parked in the abdominal aorta.  After that, the 0.035 wire was 
withdrawn and abdominal angiogram with runoffs were done. 

FINDINGS OF THE ABDOMINAL ANGIOGRAM WITH RUNOFFS:  Normal abdominal 
aorta.  Tortuous iliac arteries.  Normal left and right renal 
arteries, with disease in the left lower extremity, as described 
above.  After the diagnosis was established, intervention was 
planned. 

DETAILS OF THE INTERVENTION:  Through the 5-French Omniflush 
catheter an 0.035 stiff angled glide was advanced and using that 
0.035 wire, Omniflush catheter up and over portion was advanced into 
the contralateral common femoral artery.  After that, the Omniflush 
catheter and 5-French sheath were withdrawn and a 7-French, 45 cm 
destination sheath was used.  The tip of the destination sheath was 
parked in the superficial femoral artery.  Suggested intervention 
was carried through this destination sheath.  An 0.035 Storq wire 
was used and parked in the popliteal artery.  Then a Trialysis 
catheter,  which is parked in popliteal artery and the Trialysis 
catheter was used to deploy a filter  device in the popliteal 
artery.  After deployment of the filter device, the 0.014 filter 
wire was used for the rest of the intervention.  A atherectomy 
device was used and the filter wire was used as a rail and 
atherectomy was performed in the tightest lesion in the superficial 
femoral artery.  After that, the atherectomy device was withdrawn 
and angiogram was performed with good angiographic results, with 
increased flow in the distal vessel.


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## Jim Pawloski (Nov 25, 2013)

amym said:


> Is it appropriate to code this as 37225? CTA Done within 30 days of the procedure and diagnostic portion not billed.  Can I bill anything else?
> 
> DESCRIPTION OF PROCEDURE:  After informed consent was obtained,
> patient was brought to the endoscopy suite and access was obtained
> ...



That's what I would bill
Thanks,
Jim Pawloski, CIRCC


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