# Attempted PTA SFA



## amym (Jun 25, 2013)

Is it appropriate to bill this as 37224-52 or it gets a completely new code?

Procedure: 
1. Peripheral angiogram, selective iliac angiography and 
superficial femoral angiography with runoff. 
2. Intermittent percutaneous transluminal coronary angioplasty of 
superficial femoral artery region. 

Procedure Description: The patient was brought to the radiology 
suite per protocol. The patient was anesthetized locally with 
lidocaine and systematically with fentanyl and Versed. Access was 
obtained using 5 French micropuncture. A 5-French sheath was 
placed, through which a 5-French Omniflush catheter was placed and 
parked in the distal aorta and iliac angiogram with runoff was 
performed bilaterally. This revealed distal superficial femoral 
artery 100% chronic total occlusion. By using an angled glide, the 
iliac was crossed in an up and over fashion, and a 7-French 
destination sheath was placed. The distal end of the destination 
sheath was in the left common femoral artery, an interventional 
studies done through it. 

Intervention Details: In the interventional portion, with a glide 
catheter and an angled glidewire, the region was attempted to be 
crossed, which ended up with suboptimal results. Several wires were 
used, including over four wires. However, the region was not 
successfully crossed, and the wire repeatedly went subintimal. 
After multiple attempts at crossing, the patient's procedure results 
were suboptimal. 

Complications: None. 

Findings: The patient had an arteriovenous fistula noted at the end 
of the case, and the procedure was abandoned. 

Conclusion: Attempted percutaneous transluminal angioplasty of the 
100% chronic occlusion of the left distal superior femoral artery 
with suboptimal results.


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## Jim Pawloski (Jun 25, 2013)

amym said:


> Is it appropriate to bill this as 37224-52 or it gets a completely new code?
> 
> Procedure:
> 1. Peripheral angiogram, selective iliac angiography and
> ...



I would bill 36246 and 75710 for this case.  No mention of an intervention, just wire trying to cross a lesion.
HTH,
Jim Pawloski, CIRCC


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## Robbin109 (Jun 26, 2013)

I agree with Jim.


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