Cardiology Coding Alert

Question: Our cardiologist's operative report states that he performed a cutting-balloon atherectomy to the right femoral artery and to the in-stent restenosis in the left iliac artery. Which code should I use for this service? Iowa Subscriber

Answer: The answer depends on what the cardiologist did. The cutting balloon bears some superficial resemblance to an atherectomy, which may be why the cardiologist used that term. More likely, the cardiologist performed an angioplasty using the cutting balloon (sometimes referred to as angiotomy). If this is the case, the correct coding would be as follows:
35473 Transluminal balloon angioplasty, percutaneous; iliac
35474 femoral-popliteal
75962-26 Transluminal balloon angioplasty, peripheral artery, radiological supervision and interpretation; Professional component.
+75964-26 each additional peripheral artery, radiological supervision and interpretation (list separately in addition to code for primary procedure). If the cardiologist performed a true atherectomy, report the following codes:
35492 Transluminal peripheral atherectomy, percutaneous; iliac
35493 femoral-popliteal
75992-26 Transluminal atherectomy, peripheral artery, radiological supervision and interpretation; Professional component.
+75993-26 each additional peripheral artery, radiological supervision and interpretation (list separately in addition to code for primary procedure). Answers to You Be the Coder and Reader Questions were provided by Martha Gerant, CPC, professional coder and reimbursement specialist for Cardiology Services in Olathe, Kan.; and Cynthia Swanson, RN, CPC, a cardiac coding specialist with Seim, Johnson, Sestak & Quist in Omaha, Neb.