Anesthesia Coding Alert

Question: The surgeon performed an arteriotomy in the femoral artery to remove an aneurysm. He also inserted stents. Making incisions to access a vein always confuses me when I'm choosing a code. What's my best choice?

Vermont Subscriber

Answer: The aneurysm removal from the femoral artery was the main procedure done during the encounter, so that's the surgical code you start from. Take another look at the documentation to verify the details, but your information points to 37226 (Revascularization, endovascular, open or percutaneous, femoral, popliteal artery[s], unilateral; with transluminal stent placement[s], includes angioplasty within the same vessel, when performed). If this is correct, the primary anesthesia code associated with 37226 is 01924 (Anesthesia for therapeutic interventional radiological procedures involving the arterial system; not otherwise specified), at 6 base units. Alternate anesthesia codes are 01270 ( Anesthesia for procedures involving arteries of upper leg, including bypass graft; not otherwise specified) or 01440 (Anesthesia for procedures on arteries of knee and popliteal area; not otherwise specified), which each carry 8 base units.