Wiki Peripheral Diagnostic Angiography and Intervention

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I could use some help coding this if there is someone that's more familiar with this type coding than I am. I have been looking at 75630 and 75710 ( not bilateral so I don't think this one is right) but any suggestions will be greatly appreciated. Thanks in advance for your help!

PREOPERATIVE DIAGNOSIS: Bilateral claudication.

PROCEDURE PERFORMED:
1. A 6-French sheath, left radial artery.
2. Abdominal aortogram.
3. Percutaneous intervention of right external iliac artery utilizing Misago 8.0 x 100 mm stent.
4. Shock wave lithotripsy of right external iliac utilizing a 7.0 x 100 mm shock-wave balloon.
5. Drug-coated balloon with Boston Scientific Ranger 7.0 x 100 mm balloon.

FINDINGS:


INDICATIONS: Briefly, this is a 75-year-old male with history of worsening claudication. The patient had a CTA, which showed bilateral external iliac artery occlusions with also high-grade left common iliac artery narrowing. The patient was consented for invasive angiography.

DESCRIPTION OF PROCEDURE: After informed consent, the patient's left wrist was prepped and draped in a sterile fashion. After Allen test confirmed patency of ulnar artery, utilizing local lidocaine, a 6-French sheath into the left radial artery. The patient was administered 2000 units of heparin, 200 mcg of nitroglycerin through the sheath. A pigtail catheter was advanced to the descending aorta over a baby J-wire. Angiography obtained showed what appeared to be patent right common iliac artery. The left common iliac artery had 80% to 90% calcified proximal stenosis distal to the takeoff of the internal iliac arteries bilaterally. The external iliac arteries bilaterally appeared to be occluded 100% on both sides. There appeared to be faint reconstitution of the CFAs bilaterally. At this time, and the pigtail catheter was removed over a stiff wire. A 6-French slender distant sheath was placed, 110 cm, was placed down to the distal aorta. After this was performed, the patient was administered 10,000 heparin IV with ACTs being checked for 15 minutes thereafter to maintain ACT greater than 250. Given the fact that we had a 6-French sheath in place, which potentially would not accommodate a larger than an 8 mm balloon expandable stent, we decided that we would tackle the right iliac system first, as there was clear runway through the common iliac artery to the external iliac artery.

A 2 mm angle glide catheter, as well as a straight stiff Glidewire was advanced, and this successfully traversed the lesion in the external iliac artery and was placed into what appeared to be the SFA. This was confirmed as the catheter was placed down into the SFA and angiography was obtained, which showed that this was a widely patent SFA. We then placed an 0.014 wire into the SFA and proceeded with predilatation with a 5.0 x 100 mm Boston Scientific balloon at 8 atmospheres. After this was performed, we then proceeded with shockwave therapy of this area with a shockwave 6.0 x 100 mm balloon. Multiple shocks were delivered across this area. We then proceeded with placing a 7.0 x 100 mm Boston Scientific drug-coated balloon Ranger across this area and inflated for 3 minutes at 10 atmospheres. After this was performed, angiographic image was obtained, which showed much improved patency of the external iliac artery. We decided to proceed with stenting this vessel with a Terumo Misago 8.0 x 100 mm stent. This was deployed successfully post dilatation, and post deployment, we then post dilated this area with a Boston Scientific 7.0 x 60 mm balloon multiple sequential inflations of 8 atmospheres occurred across the stented area. After this was performed, angiographic images were obtained, which showed excellent patency of the stented area with no dissection or perforation. The internal iliac artery on this side, which did have an 80% to 90% ostial pinch, was still widely patent. At this time, the wire was pulled back, the guide catheter was switched out with a dilator, and the radial band was placed on the left wrist. The patient tolerated the procedure well with no complications.

IMPRESSION: Successful percutaneous transluminal coronary angioplasty and stenting of right 100% occluded external iliac artery utilizing shockwave therapy DCP and Misago self-expanding stent.

PLAN: The patient will have 3 hours of bed rest, start on baby aspirin and Plavix. The patient will be brought back in 1 month for intervention of his left iliac artery via the right groin, as this will allow us to use a larger sheath for potential larger balloon expandable stent in the left common iliac artery.
 
I could use some help coding this if there is someone that's more familiar with this type coding than I am. I have been looking at 75630 and 75710 ( not bilateral so I don't think this one is right) but any suggestions will be greatly appreciated. Thanks in advance for your help!

PREOPERATIVE DIAGNOSIS: Bilateral claudication.

PROCEDURE PERFORMED:
1. A 6-French sheath, left radial artery.
2. Abdominal aortogram.
3. Percutaneous intervention of right external iliac artery utilizing Misago 8.0 x 100 mm stent.
4. Shock wave lithotripsy of right external iliac utilizing a 7.0 x 100 mm shock-wave balloon.
5. Drug-coated balloon with Boston Scientific Ranger 7.0 x 100 mm balloon.

FINDINGS:


INDICATIONS: Briefly, this is a 75-year-old male with history of worsening claudication. The patient had a CTA, which showed bilateral external iliac artery occlusions with also high-grade left common iliac artery narrowing. The patient was consented for invasive angiography.

DESCRIPTION OF PROCEDURE: After informed consent, the patient's left wrist was prepped and draped in a sterile fashion. After Allen test confirmed patency of ulnar artery, utilizing local lidocaine, a 6-French sheath into the left radial artery. The patient was administered 2000 units of heparin, 200 mcg of nitroglycerin through the sheath. A pigtail catheter was advanced to the descending aorta over a baby J-wire. Angiography obtained showed what appeared to be patent right common iliac artery. The left common iliac artery had 80% to 90% calcified proximal stenosis distal to the takeoff of the internal iliac arteries bilaterally. The external iliac arteries bilaterally appeared to be occluded 100% on both sides. There appeared to be faint reconstitution of the CFAs bilaterally. At this time, and the pigtail catheter was removed over a stiff wire. A 6-French slender distant sheath was placed, 110 cm, was placed down to the distal aorta. After this was performed, the patient was administered 10,000 heparin IV with ACTs being checked for 15 minutes thereafter to maintain ACT greater than 250. Given the fact that we had a 6-French sheath in place, which potentially would not accommodate a larger than an 8 mm balloon expandable stent, we decided that we would tackle the right iliac system first, as there was clear runway through the common iliac artery to the external iliac artery.

A 2 mm angle glide catheter, as well as a straight stiff Glidewire was advanced, and this successfully traversed the lesion in the external iliac artery and was placed into what appeared to be the SFA. This was confirmed as the catheter was placed down into the SFA and angiography was obtained, which showed that this was a widely patent SFA. We then placed an 0.014 wire into the SFA and proceeded with predilatation with a 5.0 x 100 mm Boston Scientific balloon at 8 atmospheres. After this was performed, we then proceeded with shockwave therapy of this area with a shockwave 6.0 x 100 mm balloon. Multiple shocks were delivered across this area. We then proceeded with placing a 7.0 x 100 mm Boston Scientific drug-coated balloon Ranger across this area and inflated for 3 minutes at 10 atmospheres. After this was performed, angiographic image was obtained, which showed much improved patency of the external iliac artery. We decided to proceed with stenting this vessel with a Terumo Misago 8.0 x 100 mm stent. This was deployed successfully post dilatation, and post deployment, we then post dilated this area with a Boston Scientific 7.0 x 60 mm balloon multiple sequential inflations of 8 atmospheres occurred across the stented area. After this was performed, angiographic images were obtained, which showed excellent patency of the stented area with no dissection or perforation. The internal iliac artery on this side, which did have an 80% to 90% ostial pinch, was still widely patent. At this time, the wire was pulled back, the guide catheter was switched out with a dilator, and the radial band was placed on the left wrist. The patient tolerated the procedure well with no complications.

IMPRESSION: Successful percutaneous transluminal coronary angioplasty and stenting of right 100% occluded external iliac artery utilizing shockwave therapy DCP and Misago self-expanding stent.

PLAN: The patient will have 3 hours of bed rest, start on baby aspirin and Plavix. The patient will be brought back in 1 month for intervention of his left iliac artery via the right groin, as this will allow us to use a larger sheath for potential larger balloon expandable stent in the left common iliac artery.
If anyone looks at this do you see bilateral or do you see Right only? This was coded a 75710 but our auditors have an issue with that.
 
I could use some help coding this if there is someone that's more familiar with this type coding than I am. I have been looking at 75630 and 75710 ( not bilateral so I don't think this one is right) but any suggestions will be greatly appreciated. Thanks in advance for your help!

PREOPERATIVE DIAGNOSIS: Bilateral claudication.

PROCEDURE PERFORMED:
1. A 6-French sheath, left radial artery.
2. Abdominal aortogram.
3. Percutaneous intervention of right external iliac artery utilizing Misago 8.0 x 100 mm stent.
4. Shock wave lithotripsy of right external iliac utilizing a 7.0 x 100 mm shock-wave balloon.
5. Drug-coated balloon with Boston Scientific Ranger 7.0 x 100 mm balloon.

FINDINGS:


INDICATIONS: Briefly, this is a 75-year-old male with history of worsening claudication. The patient had a CTA, which showed bilateral external iliac artery occlusions with also high-grade left common iliac artery narrowing. The patient was consented for invasive angiography.

DESCRIPTION OF PROCEDURE: After informed consent, the patient's left wrist was prepped and draped in a sterile fashion. After Allen test confirmed patency of ulnar artery, utilizing local lidocaine, a 6-French sheath into the left radial artery. The patient was administered 2000 units of heparin, 200 mcg of nitroglycerin through the sheath. A pigtail catheter was advanced to the descending aorta over a baby J-wire. Angiography obtained showed what appeared to be patent right common iliac artery. The left common iliac artery had 80% to 90% calcified proximal stenosis distal to the takeoff of the internal iliac arteries bilaterally. The external iliac arteries bilaterally appeared to be occluded 100% on both sides. There appeared to be faint reconstitution of the CFAs bilaterally. At this time, and the pigtail catheter was removed over a stiff wire. A 6-French slender distant sheath was placed, 110 cm, was placed down to the distal aorta. After this was performed, the patient was administered 10,000 heparin IV with ACTs being checked for 15 minutes thereafter to maintain ACT greater than 250. Given the fact that we had a 6-French sheath in place, which potentially would not accommodate a larger than an 8 mm balloon expandable stent, we decided that we would tackle the right iliac system first, as there was clear runway through the common iliac artery to the external iliac artery.

A 2 mm angle glide catheter, as well as a straight stiff Glidewire was advanced, and this successfully traversed the lesion in the external iliac artery and was placed into what appeared to be the SFA. This was confirmed as the catheter was placed down into the SFA and angiography was obtained, which showed that this was a widely patent SFA. We then placed an 0.014 wire into the SFA and proceeded with predilatation with a 5.0 x 100 mm Boston Scientific balloon at 8 atmospheres. After this was performed, we then proceeded with shockwave therapy of this area with a shockwave 6.0 x 100 mm balloon. Multiple shocks were delivered across this area. We then proceeded with placing a 7.0 x 100 mm Boston Scientific drug-coated balloon Ranger across this area and inflated for 3 minutes at 10 atmospheres. After this was performed, angiographic image was obtained, which showed much improved patency of the external iliac artery. We decided to proceed with stenting this vessel with a Terumo Misago 8.0 x 100 mm stent. This was deployed successfully post dilatation, and post deployment, we then post dilated this area with a Boston Scientific 7.0 x 60 mm balloon multiple sequential inflations of 8 atmospheres occurred across the stented area. After this was performed, angiographic images were obtained, which showed excellent patency of the stented area with no dissection or perforation. The internal iliac artery on this side, which did have an 80% to 90% ostial pinch, was still widely patent. At this time, the wire was pulled back, the guide catheter was switched out with a dilator, and the radial band was placed on the left wrist. The patient tolerated the procedure well with no complications.

IMPRESSION: Successful percutaneous transluminal coronary angioplasty and stenting of right 100% occluded external iliac artery utilizing shockwave therapy DCP and Misago self-expanding stent.

PLAN: The patient will have 3 hours of bed rest, start on baby aspirin and Plavix. The patient will be brought back in 1 month for intervention of his left iliac artery via the right groin, as this will allow us to use a larger sheath for potential larger balloon expandable stent in the left common iliac artery.
I'm not sure that any part of the AO can be billed. The report states that a prior CTA was performed locating the issue of the area being treated. CMS guidelines state that a provider can bill for a diagnostic AO together with an intervention using a modifier only if the patient did not have a prior angiogram. CMS considers the patient to have had a prior angiogram if he or she had either a catheter-based angiogram or a CT angiogram. A second diagnostic angiogram cannot be reported on the date of percutaneous intravascular intervention procedure unless it is medically reasonable and necessary to repeat the study to further define the anatomy, there was inadequate visualization of the anatomy or there is a clinical change during the procedure that requires new evaluation outside the target area of intervention.

Hope this helps!
 
I'm not sure that any part of the AO can be billed. The report states that a prior CTA was performed locating the issue of the area being treated. CMS guidelines state that a provider can bill for a diagnostic AO together with an intervention using a modifier only if the patient did not have a prior angiogram. CMS considers the patient to have had a prior angiogram if he or she had either a catheter-based angiogram or a CT angiogram. A second diagnostic angiogram cannot be reported on the date of percutaneous intravascular intervention procedure unless it is medically reasonable and necessary to repeat the study to further define the anatomy, there was inadequate visualization of the anatomy or there is a clinical change during the procedure that requires new evaluation outside the target area of intervention.

Hope this helps!
It helps! You are helping me learn and I appreciate it! Can I ask how you would have coded this if you were doing it? I have to agree with the auditor that it was coded incorrectly but I would like to know what you would have come up with for future reference. Thank you again for responding!
 
Interesting! It never occurred to me to only use the 37221. Good to know! Thank you so much for responding! I really appreciate it!
37221 is all I would code as well. I was trying to find the documentation I had about shock wave lithotripsy but I couldn't find it. It basically said that IVL is usually performed in addition to PTA, atherectomy and/or stent and is not reported separately by the physician. If it is performed alone, it should be billed as 37799 and compared to the appropriate vessel PTA code. I will attach the info to your post if I come across it.
 
37221 is all I would code as well. I was trying to find the documentation I had about shock wave lithotripsy but I couldn't find it. It basically said that IVL is usually performed in addition to PTA, atherectomy and/or stent and is not reported separately by the physician. If it is performed alone, it should be billed as 37799 and compared to the appropriate vessel PTA code. I will attach the info to your post if I come across it.
Thank you so much! I'll ask you as well... why doesn't the criteria for the diagnostic angiography separately billable? What do I look for? I appreciate your time! Thanks again!
 
Diagnostic angiography is not billable when a CTA was performed previously. As for Margaret's question, on the physician's side of billing, you use the angioplasty codes. For the hospital side, you use the c-codes for the shockwave.
 
Diagnostic angiography is not billable when a CTA was performed previously. As for Margaret's question, on the physician's side of billing, you use the angioplasty codes. For the hospital side, you use the c-codes for the shockwave.
I should have worded my question differently... I just really want to understand this. Thank you so much for taking the time to respond. I appreciate it so much!

Per CPT, the catheter-based angiography is separately billable if a previous catheter-based angiogram is not accessible and they perform a complete diagnostics study and the decision to proceed with interventional procedure is based on that diagnostic service. A CTA is not a catheter-based angiography so how does the fact that there was a CTA done preclude billing the catheter-based angiography in addition to the intervention if catheter-based has not been performed before, a full diagnostic study is completed, and decision to proceed with the intervention is based on that catheter-based study?
 
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