Would this be coded as 37227, 37250 & 75945 or just 37227? Is the intravascular ultrasound included in the endovascular revascularization? Therapeutic or diagnostic?
THANKS!!!
The groin was sterilely prepped and draped. The skin was anesthetized
with lidocaine. The right common femoral artery was entered. A
catheter was placed in the aorta. An aortogram was performed. The
catheter was positioned at the bifurcation. A pelvic arteriogram was
performed.
The contralateral common femoral artery was selectively catheterized.
A unilateral left leg runoff was performed.
From a catheter in the ipsilateral common femoral artery a unilateral
right leg runoff was performed.
Other procedures:
I. Intravascular ultrasound: Intravascular ultrasound of the left
common femoral artery and left superficial femoral artery was
performed. After atherectomy and stent placement additional SFA
intravascular ultrasound was performed.
2. Atherectomy: Atherectomy of the candy wrap are lesions involving
the left SFA stent and the in stented restenosis was treated with 4
passes of the EV 3 LX atherectomy device.
3. Stent placement: A 7 x 16 mm stent was deployed proximal to and
overlapping the mid SFA stent and postdilated with a 6 mm balloon.
Findings:
Intravascular ultrasound:
Left SFA: There is 70% stenosis at the proximal and distal ends of the
previously placed SFA stent. There is diffuse and stent restenosis.
The proximal stenosis extends outside of the stent. Post atherectomy
there is significant debulking of the SFA. Residual narrowing in the
SFA proximal to the original stent was noted. This lesion was treated
with stent placement. Completion intravascular ultrasound shows good
result.
THANKS!!!
The groin was sterilely prepped and draped. The skin was anesthetized
with lidocaine. The right common femoral artery was entered. A
catheter was placed in the aorta. An aortogram was performed. The
catheter was positioned at the bifurcation. A pelvic arteriogram was
performed.
The contralateral common femoral artery was selectively catheterized.
A unilateral left leg runoff was performed.
From a catheter in the ipsilateral common femoral artery a unilateral
right leg runoff was performed.
Other procedures:
I. Intravascular ultrasound: Intravascular ultrasound of the left
common femoral artery and left superficial femoral artery was
performed. After atherectomy and stent placement additional SFA
intravascular ultrasound was performed.
2. Atherectomy: Atherectomy of the candy wrap are lesions involving
the left SFA stent and the in stented restenosis was treated with 4
passes of the EV 3 LX atherectomy device.
3. Stent placement: A 7 x 16 mm stent was deployed proximal to and
overlapping the mid SFA stent and postdilated with a 6 mm balloon.
Findings:
Intravascular ultrasound:
Left SFA: There is 70% stenosis at the proximal and distal ends of the
previously placed SFA stent. There is diffuse and stent restenosis.
The proximal stenosis extends outside of the stent. Post atherectomy
there is significant debulking of the SFA. Residual narrowing in the
SFA proximal to the original stent was noted. This lesion was treated
with stent placement. Completion intravascular ultrasound shows good
result.