Cardiology Coding Alert

Question: My cardiologist performed a cutting balloon atherectomy to the right femoral artery and to the in-stent restenosis of the left iliac artery. How should I code this?

Minnesota Subscriber

Answer: To assign the correct code to a peripheral service, you should assess the selectivity of the catheter position (which might be higher than the level of selectivity of the vessel in which the target lesion resides) or whether your cardiologist performed any diagnostic imaging during this procedure. Excluding discussion about coding catheter placement and diagnostic imaging, you should report the service you describe (cutting balloon atherectomy) as a simple angioplasty.

A cutting balloon is an angioplasty catheter outfitted with three small blades mounted on the outside of the balloon. As the balloon expands inside a lesion, the blades cut into the lesion, making it easier to dilate. Without these blades, your cardiologist may not be able to perform the angioplasty because the lesion might have hardened (with plaque) over time. So although these balloon tips have blades on the outside, your cardiologist performed work similar to a traditional angioplasty. The correct codes for your scenario are: