Wiki venous stent placement

[khemchand]

How to code below scenario?

Angioplasty and stent placement done in 4 different veins lower extremity.
But only 2 stents are used for 4 veins.

Need help with stent placement codes.

37238,37239? or 27238, 37239*3 ?


Indication for venography: Evaluate for stenosis, thrombosis, or occlusion
Vein catheterized: Left common iliac vein
Findings: Severe occlusion of the left common iliac vein with extensive pelvic collaterals. There is sluggish flow into the IVC.

Venoplasty
Venoplasty location: Left common iliac vein
Venoplasty balloon: Conquest 6 mm x 6 cm
Post-intervention venography: Improved flow into the IVC

Venoplasty location: Left external iliac, common femoral, and femoral vein
Venoplasty balloon: Conquest 8 mm x 10 cm
Post-intervention venography: Improved flow through the veins with decreased collaterals

Venous stent placement
Venous stent location: Iliac bifurcation to the left common femoral vein
Venous stent: Two Venovo 12 mm x 8 cm stents
Post-stenting venoplasty: Conquest 10 mm x 8 cm
Post-stenting venography: Improved flow throughout the veins with decreased pelvic collaterals

 

[danteeg65]

How to code below scenario?

Angioplasty and stent placement done in 4 different veins lower extremity.
But only 2 stents are used for 4 veins.

Need help with stent placement codes.

37238,37239? or 27238, 37239*3 ?


Indication for venography: Evaluate for stenosis, thrombosis, or occlusion
Vein catheterized: Left common iliac vein
Findings: Severe occlusion of the left common iliac vein with extensive pelvic collaterals. There is sluggish flow into the IVC.

Venoplasty
Venoplasty location: Left common iliac vein
Venoplasty balloon: Conquest 6 mm x 6 cm
Post-intervention venography: Improved flow into the IVC

Venoplasty location: Left external iliac, common femoral, and femoral vein
Venoplasty balloon: Conquest 8 mm x 10 cm
Post-intervention venography: Improved flow through the veins with decreased collaterals

Venous stent placement
Venous stent location: Iliac bifurcation to the left common femoral vein
Venous stent: Two Venovo 12 mm x 8 cm stents
Post-stenting venoplasty: Conquest 10 mm x 8 cm
Post-stenting venography: Improved flow throughout the veins with decreased pelvic collaterals

Awesome Question! So I'm a CIRCC and these procedures are what I primarily work with.
I see what you mean In terms of 4 veins Were ballooned and stented but only 2 stents were placed. however from the sounds of it this sounds like the occlusion was contiguous from the common illiac vein, to the external Iliac vein and even further into the femoral, so we would only code 37238. The two stents were placed end to end starting in common Iliac to the femoral.