leo061108
Contributor
Needing coding information on a Peripheral Intravascular Lithotripsy (IVL) procedure.
I am wondering if there is a code that I would be able to bill from the professional side?
The only codes that I am able to find are facility codes (C9765)
OR - would I not bill for the IVL and just bill the PTA/Stent?
INTERPRETATION
DESCRIPTION OF PROCEDURE: After informed consent is obtained by detailed description of risks, benefits as well as, alternative therapies, the patient elected to proceed with the aortofemoral runoff. The right femoral area was prepped and draped in normal sterile fashion. The right femoral artery was cannulated via modified Seldinger technique with placement of 5-French sheath. All catheters exchanged through this sheath. At the end of the case, all catheters were removed. The sheath was also removed and hemostasis was obtained via Angio-Seal and direct compression. The patient tolerated the procedure well. There were no complications. The patient was returned back to the room in stable hemodynamic condition.
Indication: Leg pain compatible with claudication, Abnormal ABI, PVD
FINDINGS:
1. The distal aorta has mild irregularities. No flow-limiting stenosis. No evidence of dissection or aneurysmal dilatation.
2. ABNORMAL RIGHT LEG:
a. Iliac. The common, internal and external iliacs have mild irregularities with no flow-limiting stenosis.
b. Femoral system. The common and deep femoral are widely patent. The superficial femoral artery however, has a Heavily calcified 80+% stenosis throughout the mid portion of the vessel.
c. The popliteal and infrapopliteal vessels are widely patent. There is good three-vessel runoff to the foot.
Peripherial vascular lithotripsy, PTA stent of right superficial femoral artery. The lesions were addressed with a 6.5mm Shockwave balloon. This was able to obliterate the calcium but yielded a suboptimal result with severe intimal dissection requiring stenting. Stenting was undertaken with a 6X100 Boston Scientific Drug coated nitinol stent.
RESULT: Zero percent residual stenosis, no angiographic evidence of dissection or thrombus. Restoration of brisk distal flow.
OVERALL IMPRESSION: Successful percutaneous transluminal angioplasty, Shockwave intravascular lithotripsy, and stent of the right superficial femoral artery going from over 80% percent initial stenosis to zero percent residual stenosis with restoration of distal flow.
I appreciate any help or information!! TIA!!
I am wondering if there is a code that I would be able to bill from the professional side?
The only codes that I am able to find are facility codes (C9765)
OR - would I not bill for the IVL and just bill the PTA/Stent?
INTERPRETATION
DESCRIPTION OF PROCEDURE: After informed consent is obtained by detailed description of risks, benefits as well as, alternative therapies, the patient elected to proceed with the aortofemoral runoff. The right femoral area was prepped and draped in normal sterile fashion. The right femoral artery was cannulated via modified Seldinger technique with placement of 5-French sheath. All catheters exchanged through this sheath. At the end of the case, all catheters were removed. The sheath was also removed and hemostasis was obtained via Angio-Seal and direct compression. The patient tolerated the procedure well. There were no complications. The patient was returned back to the room in stable hemodynamic condition.
Indication: Leg pain compatible with claudication, Abnormal ABI, PVD
FINDINGS:
1. The distal aorta has mild irregularities. No flow-limiting stenosis. No evidence of dissection or aneurysmal dilatation.
2. ABNORMAL RIGHT LEG:
a. Iliac. The common, internal and external iliacs have mild irregularities with no flow-limiting stenosis.
b. Femoral system. The common and deep femoral are widely patent. The superficial femoral artery however, has a Heavily calcified 80+% stenosis throughout the mid portion of the vessel.
c. The popliteal and infrapopliteal vessels are widely patent. There is good three-vessel runoff to the foot.
Peripherial vascular lithotripsy, PTA stent of right superficial femoral artery. The lesions were addressed with a 6.5mm Shockwave balloon. This was able to obliterate the calcium but yielded a suboptimal result with severe intimal dissection requiring stenting. Stenting was undertaken with a 6X100 Boston Scientific Drug coated nitinol stent.
RESULT: Zero percent residual stenosis, no angiographic evidence of dissection or thrombus. Restoration of brisk distal flow.
OVERALL IMPRESSION: Successful percutaneous transluminal angioplasty, Shockwave intravascular lithotripsy, and stent of the right superficial femoral artery going from over 80% percent initial stenosis to zero percent residual stenosis with restoration of distal flow.
I appreciate any help or information!! TIA!!