Wiki Femoral Viabahn Stent - Aneurysm Repar

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cweavercpc

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Thoughts Please!!! I could not find a Dr. Z reference on this and do not know if this would be the peripheral stent code of if it mus be the unlisted code. Has anyone had to code/bill this? My MAC is Cahaba.

Any input appreciated.

Thanks,
Courtney :)



INDICATION: Left superficial femoral artery aneurysm, _____
significant size large.
PROCEDURE: Informed consent was obtained from the patient after
explaining to her the risks of the procedure. Right common femoral
artery access was obtained using modified Seldinger technique, and a
7-French introducer sheath was used to cannulate the right common
femoral artery.
Pigtail catheter was advanced across the aortoiliac bifurcation and
positioned in the right common femoral artery. A 7-French
Destination sheath was advanced across the aortoiliac bifurcation and
positioned in the left common femoral artery. Heparin was given for
anticoagulation. A Prowater wire was advanced across the lesion
_____ evidence of large left superficial femoral artery aneurysm. A
7.0 x _____ endograft was placed in the left superficial femoral
artery and postdilated with a 6.0 x 40 balloon atmospheres _____ the
lesion was repaired _____ aneurysm was completely repaired.
IMPRESSION:
1. Left superficial femoral artery aneurysm repair with endograft
with no complications.
2. A Mynx device was deployed in the right common femoral artery
with no complication. The patient did fairly well.
DISPOSITION: The patient can be discharged home.
DIET: American Heart Association Step II diet.
DISCHARGE INSTRUCTIONS: Exercise as tolerated.
FOLLOWUP: Follow up with me as an outpatient in a few weeks _____
right common femoral artery stenosis.
 
I just recently came across this situation as well, and the feedback I received was to use the codes in the endovascular revascularizaton (open or percutaneous, transcatheter) 37220-37235 code range. I was tempted to go with the 37799 at first, as well, but could not find any information supporting the use of that code instead of the revascularization codes.

HTH
 
Endograft to femoral

Thank you Robin!!! That is also what I am leaning towards. My current problem is that when I put it through our 3M it keeps taking me to 37204?? I really wish we could find some kind of guidance in writing.

Thanks so much!
 
There is written guidance in the December 2011 issue of CPT Assistant (pasted below). You can use the revascularization codes for placement of a covered stent regardless of the indication.

Jackie Miller, RHIA, CCS-P, CPC
Coding Strategies, Inc.

Question 1: Is it appropriate to report code 37226, Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(s), unilateral; with transluminal stent placement(s), includes angioplasty within the same vessel, when performed, for transcatheter placement of a covered stent to treat a popliteal artery aneurysm? The procedure is clearly a lower extremity arterial stent placement, but it is performed for an aneurysm rather than an occlusive disease. Jackie Miller, RHIA, CPC, CCS-P, PCS

Answer 1: CPT code 37226 is not specific for occlusive atherosclerotic disease. It should be used any time a stent is placed in the femoral or popliteal artery, irrespective of the indication.
 
Thank you for this information. I will print and save this. I'm thankful there are experienced cardiology coders out there that are willing to provide feedback to those of us that are new.

All the help is greatly appreciated.
 
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