# Confused with new lower extremity codes



## jessica1974 (Jan 25, 2011)

I have been researching the coding for the lower extremity stenting and PTA. I am under the impression that the new codes include the catheter placement and S&I codes. Is this correct? I cannot seem to find anything stating that for sure but the CPT says the codes include all work of accessing the vessels. Which leads me to believe that includes the catheter placement and radiology codes. Just wanting verification that I am understanding this correctly.


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## kbazarte@yahoo.com (Jan 25, 2011)

email me at kelly.bazarte@trinityhealth.org and i will send you the low ext. revascularization codes


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## manda12 (Jan 26, 2011)

kelly could i get a copy of that too please amanda.solomon@jax.ufl.edu


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## theresa.dix@tennova.com (Jan 27, 2011)

jessica1974 said:


> I have been researching the coding for the lower extremity stenting and PTA. I am under the impression that the new codes include the catheter placement and S&I codes. Is this correct? I cannot seem to find anything stating that for sure but the CPT says the codes include all work of accessing the vessels. Which leads me to believe that includes the catheter placement and radiology codes. Just wanting verification that I am understanding this correctly.



Jessica,

Ok Im going to try and explain the way I am understanding this. THis comes from Medlearn seminar I attended.

Lower extremity interventions:
COde to the highest value of interventions;

stents are kings
athrectomies are queens
Angioplasties are jacks

Diagnostic imaging from which a medical decision is made to intervene IS coded separately
Cath placement is included within the intervention.

There is NOT a corresponding S&I code for the interventions,like there use to be.

So what this means is.

WHen an intervention is done the cath placement is NOT coded BUT the S & I for the cath placement is.

when they say S & I is included in the intervention they mean the S & I (that we used to code with the stent code ) is included. NOt the S & I for the cath placement. Read the above carefully and you will see this.

Let me know if you dont understand I can try and help again.


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## jessica1974 (Jan 27, 2011)

So we cannot code cath placement but can use the S&I codes for a runoff (75716) etc if they are performed and intervention is lead to.  I think I understand. Thanks for your help.


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## theresa.dix@tennova.com (Jan 27, 2011)

jessica1974 said:


> So we cannot code cath placement but can use the S&I codes for a runoff (75716) etc if they are performed and intervention is lead to.  I think I understand. Thanks for your help.




Yes this is what Medlearn said. I have a question for you now! On the LHC/stent do we add 59 modifier? I have heard some say yes some no.


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## Jim Pawloski (Jan 28, 2011)

theresa.dix@ethc.com said:


> Jessica,
> 
> Ok Im going to try and explain the way I am understanding this. THis comes from Medlearn seminar I attended.
> 
> ...



Can I add to the above;
In the lecture, this is how many codes you can have.
Pelvis - 3 codes, one each for Common Iliac, External Iliac, and External Iliac.
Common Femoral to Popliteal - only one code
Lower leg - One each for Anterior Tibial, Posterior Tibial and Peroneal.

The diagnostic angio is coded with a modifier -59, has to be a complete study.
The intervention includes cath position and any injections/imaging.

HTH,
Jim Pawloski, CIRCC, R.T. (CV)


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## theresa.dix@tennova.com (Jan 28, 2011)

Jim Pawloski said:


> Can I add to the above;
> In the lecture, this is how many codes you can have.
> Pelvis - 3 codes, one each for Common Iliac, External Iliac, and External Iliac.
> Common Femoral to Popliteal - only one code
> ...




Jim,
 thank you for adding that!


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