Wiki Code for subclavian artery angioplasty and stenting

drhoads

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Please help code op-report: Left subclavian artery engioplasty and stenting.

Description of procedure: Access was obtained through right common femoral artery using fluoroscopic guidance. Wire was placed up through the right iliac system into the aorta. We placed a 7-French 70 cm sheath all the way up into the thoracic aorta. We then used a Bern catheter and a glidewire t select he left subclavian artery. 4000 units of intravenous heparin were give prior to angioplasty and stenting and 2 gm of Ancef were infused prior to stenting. The stenosis was visualized and crossed. We then exchanged wires for a Rosen wire. The sheath would not advance across the stenosis. We then placed a 9x2 balloon to postdilate this in multiple areas. A completion angiogram showed excellent results. The wires, catheters and sheaths were removed and 8-French Angioseal was placed in the groin and good hemostasis was obtained.

Any help in coding this report would be greatly appreciated.

Thank you!
 
Please help code op-report: Left subclavian artery engioplasty and stenting.

Description of procedure: Access was obtained through right common femoral artery using fluoroscopic guidance. Wire was placed up through the right iliac system into the aorta. We placed a 7-French 70 cm sheath all the way up into the thoracic aorta. We then used a Bern catheter and a glidewire t select he left subclavian artery. 4000 units of intravenous heparin were give prior to angioplasty and stenting and 2 gm of Ancef were infused prior to stenting. The stenosis was visualized and crossed. We then exchanged wires for a Rosen wire. The sheath would not advance across the stenosis. We then placed a 9x2 balloon to postdilate this in multiple areas. A completion angiogram showed excellent results. The wires, catheters and sheaths were removed and 8-French Angioseal was placed in the groin and good hemostasis was obtained.

Any help in coding this report would be greatly appreciated.

Thank you!

I usually agree with Julie but not for this case. All that I would code is:
37205/75960 for the stent placement and
36215 for the catheter placement into the left subclavian artery.
I would not bill for angiography because I do not see a diagnostic exam and interpretation.
I would also not bill for angioplasty because I do not think the documentation supports a primary angioplasty attempt that was insufficient, and lead to subsequent stent placement. This seems to be pre-and post dilation.

Clear as mud right? :)

HTH
 
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