Wiki Catheter codes during stent placement

[Jim Pawloski]

Hello everyone,

I looking for some help. A patient had a Lt SFA stent placement from the right femoral access, using a long sheath. He then pulled the long sheath out of the left leg, and made an exchange for a short sheath and performed a stent placement in the right common iliac artery. I billed for catheter placement 36247-lt, and then for the appropriate stent placements. The doctor want me to bill 36245 for the sheath placement for the stent placement on the right.

I say he can't bill the 36245-rt, he says he can. Who is right?

Thanks,
Jim Pawloski, CIRCC

 

[nicolechar]

I would suggest using a modifier 52 or 53 with 36245. The reason I say this is because it seems as though the physician decided not to stent the the right femoral artery for some reason not mentioned in your question. Use 36247 (LT) as well because essitially this is what was performed.

 

[dpeoples]

Hello everyone,

I looking for some help. A patient had a Lt SFA stent placement from the right femoral access, using a long sheath. He then pulled the long sheath out of the left leg, and made an exchange for a short sheath and performed a stent placement in the right common iliac artery. I billed for catheter placement 36247-lt, and then for the appropriate stent placements. The doctor want me to bill 36245 for the sheath placement for the stent placement on the right.

I say he can't bill the 36245-rt, he says he can. Who is right?

Thanks,
Jim Pawloski, CIRCC

Jim,
You are correct, IMO. It does not matter how many different catheters/sheaths the physician uses to achieve the desired result, code only for the catheter end position from the same access. The only exception to that is during a follow up of thrombolytic therapy (37209/75900).

HTH