Wiki LE Revascularization and 2 access sites

[Robbin109]

If the MD:

Obtain access from the left leg, advances to the right with catheter placed at right common fem, then does angio. Pt has total occlusion of AT. He then places a sheath in the right Pop artery and performs Atherectomy from there, is the first cath placement code from the left side into the common fem coded?

Thanks!

 

[dpeoples]

If the MD:

Obtain access from the left leg, advances to the right with catheter placed at right common fem, then does angio. Pt has total occlusion of AT. He then places a sheath in the right Pop artery and performs Atherectomy from there, is the first cath placement code from the left side into the common fem coded?

Thanks!

I would.
HTH

 

[Robbin109]

I agree. I actually just found this:

The revascularization codes include “the work of accessing and selectively catheterizing the vessel.� In most cases you should not assign a catheterization code together with a revascularization code. However, there are three exceptions to this rule:

• The angiograms and the revascularization are performed via different accesses (punctures).

• Catheterization for the angiogram involves a higher degree of selectivity than the catheterization for the revascularization procedure.

• The physician catheterizes a different vascular bed than the one where the revascularization is performed.

 

[louietesha]

Revascularization of lower extrem

My first question is was there really a second access or did he just more the catheter/sheath down to the pop and then do the intervention?

 

[louietesha]

My first question would be was there really two separate access sites? Or did he just move the catheter and placed it with the sheath in the pop to do the intervention? I see this all the time. However I have not seen only on rare occasions that they actually have a second access site. But if it is a true second access site then you code to the furthest catheter placement that they went for each access site.

Hope this helped