amym
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Is CPT 37224 the only code I can bill here?
PROCEDURES PERFORMED:
1. Selective lower extremity imaging.
2. Percutaneous transluminal angioplasty of the left superficial femoral
artery/popliteal arteries.
CLINICAL SUMMARY: The patient has presented with severe claudication in
both legs. He underwent right superficial femoral artery percutaneous
transluminal angioplasty with marked improvement in his claudication
symptoms and healing of the ulcer on the right leg. He now comes in for
percutaneous transluminal angioplasty of the left superficial femoral
artery, which is 95% occluded.
PROTOCOL: Due to sharp angulation of the bifurcation of the aorta,
antegrade stick was preferred, which was performed however due to scar
tissue there was some difficulty in advancing the sheath and therefore
an Amplatz stiff straight wire was then advanced over a dilator and
subsequently a 7-French sheath was placed with the intention of possibly
using stenting. The lesion was identified as a 95% focal stenosis in
the superficial femoral artery/popliteal junction and there was a
secondary lesion, which was in the popliteal artery right at the knee
joint, which was at least 70% in severity. Once the balloon inflation
was performed using 5 x 40 balloon, marked improvement was noted
in this lesion with less than 30% residual narrowing with margins and no
evidence of dissection and good flow was noted.
The second lesion in the popliteal artery was also dilated using the
same 5 x 40 balloon with some improvement with no dissection. At this
point, distal flow was also imaged with the pictures of the trifurcation
taken in magnification, which reveals that the posterior tibial artery
has a 90% stenosis and two-vessel runoff is present in the foot.
FINDINGS: Successful percutaneous transluminal angioplasty of the left
superficial femoral artery/popliteal arteries with 5 x 40 balloon with
stenosis reduction from 95% to less than 30%.
PROCEDURES PERFORMED:
1. Selective lower extremity imaging.
2. Percutaneous transluminal angioplasty of the left superficial femoral
artery/popliteal arteries.
CLINICAL SUMMARY: The patient has presented with severe claudication in
both legs. He underwent right superficial femoral artery percutaneous
transluminal angioplasty with marked improvement in his claudication
symptoms and healing of the ulcer on the right leg. He now comes in for
percutaneous transluminal angioplasty of the left superficial femoral
artery, which is 95% occluded.
PROTOCOL: Due to sharp angulation of the bifurcation of the aorta,
antegrade stick was preferred, which was performed however due to scar
tissue there was some difficulty in advancing the sheath and therefore
an Amplatz stiff straight wire was then advanced over a dilator and
subsequently a 7-French sheath was placed with the intention of possibly
using stenting. The lesion was identified as a 95% focal stenosis in
the superficial femoral artery/popliteal junction and there was a
secondary lesion, which was in the popliteal artery right at the knee
joint, which was at least 70% in severity. Once the balloon inflation
was performed using 5 x 40 balloon, marked improvement was noted
in this lesion with less than 30% residual narrowing with margins and no
evidence of dissection and good flow was noted.
The second lesion in the popliteal artery was also dilated using the
same 5 x 40 balloon with some improvement with no dissection. At this
point, distal flow was also imaged with the pictures of the trifurcation
taken in magnification, which reveals that the posterior tibial artery
has a 90% stenosis and two-vessel runoff is present in the foot.
FINDINGS: Successful percutaneous transluminal angioplasty of the left
superficial femoral artery/popliteal arteries with 5 x 40 balloon with
stenosis reduction from 95% to less than 30%.
