NOTICE: Due to inclement weather conditions shipping orders may be delayed on orders.
Items Tagged: stent
Oct 27, 2017
October 2017 Q & A
Question: Can you bill 61635 and 61624 for the stent assisted coiling?
Diagnostic cerebral angiogram and stent-assisted coiling. Subsequently the stent was placed and unsheathed through the supraclinoid and ophthalmic segment of the ICA. DSA in AP and lateral views demonstrated optimal wall apposition. At that time the coil was introduced completely into the aneurysmal dome. Under new roadmapping a 5 x 15 hydroframe coil was introduced into the dome.
Sep 28, 2017
September 2017 Q & A
Question: Limbs AV Fistula Declot & Stenting Failure; TPA and Repeat Stent for Extravasation
AV left forearm graft fistulogram showed extensive thrombus in main draining vein up to the level of the distal third of the humerus. Crossing sheaths placed. Angiojet catheter used to treat arterial and venous anastamosis. It worked for arterial but not venous. Angioplasty of arterial anastomosis, with arterial flow re-established. Stent was placed across venous anastamosis to improve outflow. Patient continued to clot despite administration of 10,000 units of heparin during the procedure. Multiple passes again made with the angiojet. Flow was not re-established.
Nov 28, 2016
November 2016 Q & A
Question: Cutting Angioplasty with Perforation
Under fluoroscopic guidance, the upper arm dialysis access fistula was catheterized and fistulogram was obtained. There was a greater than 50% stenosis within the mid cephalic vein that was dilated with an 8 mm angioplasty balloon and high pressure angioplasty balloon with no effect. The lesion was then dilated with a cutting balloon. Following angioplasty with a cutting balloon there was a leak identified from the cephalic vein. Multiple attempts at balloon tamponade were performed, and these were unsuccessful at controlling the leak. An 8 mm x 6 cm fluency stent graft was then placed across the leak and dilated to 8 mm. Follow-up fistulogram was obtained and showed free flow of contrast through the stent. Cephalic arch and central veins are patent. The arterial anastomosis is widely patent. There is a small pseudoaneurysm in the cephalic vein near the arterial anastomosis.
I am assigning codes 36147 and 37238. Should something be stated about the perforation? If so, how should this be coded?
Oct 25, 2016
October 2016 Q & A
Question: Femoral Stent to Stop Bleeding
A patient had a TAVR procedure and had continued bleeding of the femoral artery, so a femoral artery stent was deployed. What code do I use for this service? I see that the CPT book states, "Codes 37220-37235 are to be used to describe lower extremity endovascular revascularization services performed for occlusive disease," so I know that these codes do not apply since the stent was deployed for hemostasis. Is this a billable service?
Sep 26, 2016
September 2016 Q & A
Question: Brachial Cutdown Not Involving AAA Repair
I have used 34834 for a brachial artery cutdown for AAA repair. Can you please advise on CPT Code for cutdown of brachial artery for repair of SFA aneurysm with a Viabahn Stent?