Wiki Catheter & Angio Codes

[AmandaM.318414]

Good morning,

Will someone please help me confirm what my cardiologist is billing for these procedures:

PROCEDURES PERFORMED:
1. Right Femoral Angiogram with Peripheral Runoff
2. CSI Atherectomy of L CFA
3. Left Iliac Angiogram with Peripheral Runoff
4. Angioplasty of L CFA, L Proximal SFA
5. Angioplasty and stenting of L Distal SFA
6. Angioseal 6F R CFA

36140 (?)
36246
75630-26
75716-26
37220
37236
75962-26

Here are notes:

Using a micropuncture needle, the right femoral artery was accessed and a 6 french introducer sheath was inserted using a modified Seldinger technique. The IMA catheter was used to engage the Left Common Iliac Artery. Glide wire placed into Prox SFA Occlusion and wire switched out for a Supracore wire. A 6F Ansel sheath was used then cross over into L CFA, a Regalia XS wire was used to cross to Prox SFA occlusion, then a quickcross was advanced distal to lesion, wire removed and glidewire used to advance into distal SFA and subintimal technique used to re-enter distal to occlusion back into true lumen. Angiograms with runoff performed. EV3 5 X 60 X 135 cm balloon advanced into distal SFA and inflated to 10 atm. Next balloon brought back into proximal SFA and inflated to 10 atm. Next wire switched out for a Viperwire, 2.0 mm atherectomy device advanced into CFA and 4 runs performed at 60,0000 , 90,000 and 120,000 rpms. Next, a Absolute SES released in distal SFA 6.0 X 100 mm X 135 cm, 5 mm balloon taken back into stent and inflated to 14 atm multiple times. Angiograms performed with right and left runoffs. Angioseal deployed to right groin


Thank you,

 

[dpeoples]

Good morning,

Will someone please help me confirm what my cardiologist is billing for these procedures:

PROCEDURES PERFORMED:
1. Right Femoral Angiogram with Peripheral Runoff
2. CSI Atherectomy of L CFA
3. Left Iliac Angiogram with Peripheral Runoff
4. Angioplasty of L CFA, L Proximal SFA
5. Angioplasty and stenting of L Distal SFA
6. Angioseal 6F R CFA

36140 (?)
36246
75630-26
75716-26
37220
37236
75962-26

Here are notes:

Using a micropuncture needle, the right femoral artery was accessed and a 6 french introducer sheath was inserted using a modified Seldinger technique. The IMA catheter was used to engage the Left Common Iliac Artery. Glide wire placed into Prox SFA Occlusion and wire switched out for a Supracore wire. A 6F Ansel sheath was used then cross over into L CFA, a Regalia XS wire was used to cross to Prox SFA occlusion, then a quickcross was advanced distal to lesion, wire removed and glidewire used to advance into distal SFA and subintimal technique used to re-enter distal to occlusion back into true lumen. Angiograms with runoff performed. EV3 5 X 60 X 135 cm balloon advanced into distal SFA and inflated to 10 atm. Next balloon brought back into proximal SFA and inflated to 10 atm. Next wire switched out for a Viperwire, 2.0 mm atherectomy device advanced into CFA and 4 runs performed at 60,0000 , 90,000 and 120,000 rpms. Next, a Absolute SES released in distal SFA 6.0 X 100 mm X 135 cm, 5 mm balloon taken back into stent and inflated to 14 atm multiple times. Angiograms performed with right and left runoffs. Angioseal deployed to right groin


Thank you,

I see:
37227 for stent/athrectomy in femoral artery (does not matter if CFA or SFA, femoral is femoral), and this is the only code the document supports.

You loose 36140 when you advance the catheter, and 36246 is included with the procedure so you loose that as well. I did not see an angioplasty of the iliac to warrant 37220. Nor do I see an interpretation of images to warrant 75716 or 75630 (which can't be billed together anyway per most payors).
Lastly, 37236 is for non lower extremties, as is 75962, so neither of those codes should be applied.

I hope you don't have too much difficulty convincing him/her...good luck.

HTH