Wiki RCF and Rt Pedal Access

[hipmom916]

Pt with known occulsions at the origion of the rt anterior tib and then occluded at the mid portion. Successful atherectomy at the origion from the RCF. Unable to pass the wire through the mid occlusion, went to rt. pedal access, but could not pass the wire through the mid occlusion of the anterior tib. I would not code 36104 for the access in the pedal correct? It would just be the 37229.

 

[dpeoples]

Pt with known occulsions at the origion of the rt anterior tib and then occluded at the mid portion. Successful atherectomy at the origion from the RCF. Unable to pass the wire through the mid occlusion, went to rt. pedal access, but could not pass the wire through the mid occlusion of the anterior tib. I would not code 36104 for the access in the pedal correct? It would just be the 37229.

I will assume you meant 36140 for the rt pedal access...technically yes, you can code the second access and modify that code with 59. It is subjective I know but without more documentation I would probably not code for a failed access when there is already a code for a successful revascularization.JMO

HTH

 

[hipmom916]

Thanks for the reply! It was not the answer I was excpecting so...for my education and so I can understand...I was going with the fact ,that access, and cath placement is included with lower extremity intervention. Even if he would have been successful from the pedal, I would have thought not to code the access. If he would have not been successful from either site I would have coded 36140 (yes that's what I meant, lol) x2?

Another senario I just came across was rcf and rt pedal access with a through and through wire ,with an intervention. If I remeber, one of Dr. Z's webinars said not to code the second access site, because of the cath placement rule. I see you have your CIRCC, which I hope to have by the end of the year! I appreciate your knowledge and input.

Thanx,

LW