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Need guidance with coding intervention

louise Posted Mon 09th of September, 2019 09:15:37 AM
Ultrasound guided percutaneous access of right common femoral artery (CFA) . Introduction of catheter into aorta. Selective catheterization of left popliteal artery. 37224 Third order left lower extremity arteriogram with RS&I. Balloon angioplasty of distal anastomotic stenosis with 4 x 40 mm Armada balloon and 5 x 40 mm Mustang balloon, Right lower extremity angiogram --- Percutaneous closure of Right CFA access with Mynx device
SuperCoder Answered Tue 10th of September, 2019 08:46:03 AM

Hi,

Thanks for your question.

As per code 37224 the provider makes a small incision or inserts a needle through the skin to puncture the occluded, or blocked, femoral or popliteal artery. He then introduces a guidewire through the opening and uses this guide wire to introduce the catheter. He uses arteriography as an imaging guidance, and using the guidewire, introduces a balloon catheter into the artery, advancing it to the site of occlusion. He confirms its position using angiography. He then inflates the balloon at the site of the occlusion and expands it against the wall of the lumen to increase the diameter of the vessel. Finally, the provider withdraws the catheter and sutures the incision or site of puncture in the blood vessel.

Lower extremity endovascular revascularization codes all include the work of accessing and selectively catheterizing the vessel, traversing the lesion, radiological supervision and interpretation directly related to the intervention(s) performed, embolic protection if used, closure of the arteriotomy by pressure and application of an arterial closure device or standard closure of the puncture by suture, and imaging performed to document completion of the intervention in addition to the intervention(s) performed.

The documentation suggest use of code 37224.

Hope this helps.

Thanks.

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