Q&A peripheral angioplasty and stent of the leg

[Magda]

can someone please help me code this

 

[Lori Woods]

Good question I was led to V43.4 blood vessel replaced by other means. I was surprised it was a V code but the note says these categories are intended for use when these conditions are recorded as "diagnosis" or "problems." So I am curious if this would be correct.

 

[Carolyn Heath]

Magda, could you post the whole coding scenario? That may help us understand the question better and we can be in a better position to help you.

 

[Magda]

Good question I was led to V43.4 blood vessel replaced by other means. I was surprised it was a V code but the note says these categories are intended for use when these conditions are recorded as "diagnosis" or "problems." So I am curious if this would be correct.

Thank you Lori for your help but I am actually looking for a procedure code for and angioplasty of the lower extremities if you can help me out that would be great I am going to post the report right now

 

[Magda]

Magda, could you post the whole coding scenario? That may help us understand the question better and we can be in a better position to help you.

Thank you Carolyn I will post the report that I finally received from the doctor and once again thank you for your help

 

[Magda]

Operative Report​

Procedure performed​

1. Left lower extremity angiography.​

2. Angioploasty of the left popliteal and left superficial femoral artery.​

​

Complications: None​

​

Indications: Underlying critical stenosis of the popliteal arteries more than 95%​

​

Procedure in Detail​

We had a #6-French arterial line from the right fermoral artery, and now we have put left internal mammary artery catheter, which had been passed with the help of the Glidewire into the left iliac artery. Subsequently, glidewire was passed all the way to the anterior tibial artery and subsequently now we have put the catheter, which is a kumpe access catheter, which had been passed into the left iliac artery, and now we subsequently have put the long wire which is a choice PT wire, which was put all the way to the left anterior tibial artery. Subsequently, the Kumpe catherter had been discontinued. Subsequently, I put 2.5 X 40 mm balloon and angioplasty had been done in the entire popliteal artery and the balloon had been discontinued. Subsequently, the angioplasty was done x2 including the left superficial femoral artery and also left popliteal artery. now, Subsequently the balloon wire have all been discontinued. The result was satisfactory.​

Prior to performing the procedure, there was underlying 95% stenosis of the left popliteal, lower superficial femoral arteries, and left superficial, and after performing balloon angioplasty, the arteries are widely open. The residual stenosis is less than 20%.​

​

Conclusion: this was a successful procedure.​

Plan: Advised to be on aspirin​

 

[Carolyn Heath]

I will give this a shot:
73725 - angiography of the lower extremity -- not sure a modifier is to be used, but if it is, use -LT
37224 - angioplasty of the popliteal and superficial femoral artery, unilateral - no modifier

 

[Magda]

thank you so much Carolyn and you read my mine I been reading the super coder for 37224 for the angioplasty and I was wondering if it required a modifier 26 because if it did according to the super coder we will not get any reimburstment so thank you for letting me know that now modifier is needed

 

[Carolyn Heath]

You are welcome. I used the CPT manual to get my information.

 

[kstringer]

thank you so much Carolyn and you read my mine I been reading the super coder for 37224 for the angioplasty and I was wondering if it required a modifier 26 because if it did according to the super coder we will not get any reimburstment so thank you for letting me know that now modifier is needed

This does not require the modifier and you can only bill 73725 if it is truly diagnostic-meaning there was no knowlege of blockage prior to exam- everything is bundled into the 37224.