Cardiology Coding Alert

Question: My cardiologist's documentation indicates, "The patient underwent a peripheral angioplasty with cryoplasty balloon of critical stenosis in the distal left SFA and left popliteal artery." He accessed the vessel from the right femoral artery access site. How should I report this?

Georgia Subscriber

Answer: For the superficial femoral artery (SFA) intervention, you can report 35474 (Transluminal balloon angioplasty, percutaneous; femoral-popliteal) and 75962-26 (Transluminal balloon angioplasty, peripheral artery, radiological supervision and interpretation; professional component).

Assuming that these two interventions address separate lesions (rather than one lesion that overlaps the two vessels), you would also need to code for the popliteal PTA with 35474-59 (Transluminal balloon angioplasty, percutaneous; femoral-popliteal; distinct procedural service) and +75964-26 (Transluminal balloon angioplasty, each additional peripheral artery, radiological supervision and interpretation [list separately in addition to code for primary procedure]).

Watch for: The contralateral popliteal cath placement is 36247 (Selective catheter placement, arterial system; initial third order or more selective abdominal, pelvic, or lower extremity artery branch, within a vascular family). Therefore, you should not separately report any lesser order cath placement codes (36140, 36200, 36245 and 36246) for this intervention.