Anesthesia Coding Alert

Question: What surgical and anesthesia codes apply to balloon dilatation of pulmonary veins? A cardiologist performed the procedure through a catheter in the cardiac cath lab.

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Answer: The best surgical code may depend on how the cardiologist performed the procedure. Try 35460 (Transluminal balloon angioplasty, open; venous) if it was an open procedure, or 35476 (Transluminal balloon angioplasty, percutaneous; venous) if it was percutaneous.

Code 35460 crosses to anesthesia code 01850 (Anesthesia for procedures on veins of forearm, wrist, and hand; not otherwise specified) and several alternatives. But this surgery occurs in the chest and is more intense than forearm surgery described by 01850 (the physician may have started the catheter in the forearm, but this isn't the treatment area), so a code like 01926 (Anesthesia for therapeutic interventional radiologic procedures involving the arterial system; intracranial, intracardiac, or aortic) is more appropriate. Code 35476 corresponds with anesthesia code 01932 (Anesthesia for therapeutic interventional radiologic procedures involving the venous/lymphatic system [not to include access to the central circulation]; intrathoracic or jugular).

You Be the Coder and Reader Questions were reviewed by Barbara Johnson, CPC, MPC, anesthesia coder for Loma Linda University Anesthesiology Medical Group in Loma Linda, Calif.