# PTA of R SFA and Left LE Angiogram



## AshleyMartin (Aug 19, 2011)

How do I code a PTA of the right SFA along with a left lower exremity angiogram?

Procedure:
The patient was brought to the cath lab and prepped and draped in a sterile fashion. Access was obtained via the left femoral artery via modified Seldinger technique after 1% lidocaine was used to anesthetize the area. We introduced a 5-French Omni flush catheter over a 0.35 J-wire. This was used to cross over using a stiff angled Glidewire. We then exchanged for a stiff Amplantz wire and were able to get a Raabe sheath over the aortoiliac bifurcation. We used a 6 x 100 Boston Scientific Mustang balloon. Two inflations were done in the proximal and mid portion of the SFA up to 10 atmospheres. Three hundred mcg of nitro was given post balloon dilatation. A runoff shot was taken. Good result was achieved. The patient tolerated the procedure well. There were no complications. Heparin was used for anticoagulation during the procedure. A 6-French Angio-seal was deployed at the end to obtain hemostasis at the arterial access sire.

Findings:
The left SFA has serial 70% to 90% lesions in the proximal to mid portion of the vessel. The popliteal is patent. There is two and a half vessel runoff below the knee. 

Intervention Details:
The serial lesions in the SFA were reduced to less than 10% using a 6 x 100 Mustang balloon dilated up to 10 atmospheres. 

Conclusions:
1. Peripheral arterial disease with significant ABI values and Fontaine IIb symptoms.
2. Status post successful percutaneous transluminal angioplasty of the right SFA.

Thanks!


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## K.hancin (Aug 19, 2011)

I passed the CPC exam in January but as of yet, have no work experience as a coder. So, with that being said, what do you think of:

37224 Revascularization, endovascular, open or percutaneous, femoral/popliteal artery(s), unilateral; with transluminal angioplasty.

75710-59 Angiography, extremity, unilateral


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## Jim Pawloski (Aug 22, 2011)

K.hancin said:


> I passed the CPC exam in January but as of yet, have no work experience as a coder. So, with that being said, what do you think of:
> 
> 37224 Revascularization, endovascular, open or percutaneous, femoral/popliteal artery(s), unilateral; with transluminal angioplasty.
> 
> 75710-59 Angiography, extremity, unilateral



I would not bill for the lower extremity because IMO it looks like the doctor intention was angioplasty.  The angio was after the PTA, which is not billable.
HTH,
Jim Pawloski, CIRCC


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## donnajrichmond (Aug 22, 2011)

Jim Pawloski said:


> I would not bill for the lower extremity because IMO it looks like the doctor intention was angioplasty.  The angio was after the PTA, which is not billable.
> HTH,
> Jim Pawloski, CIRCC



I agree, as documented, the angiogram cannot be coded.


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## K.hancin (Aug 22, 2011)

Thanks for clarifying, I appreciate it.
Karen


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## AshleyMartin (Aug 23, 2011)

Thanks everyone! I appreciate the help!


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