Ask Dr. Z

Please help us understand when it is appropriate to use the additional non-coronary IVUS. Our physician placed a subclavian stent for known occlusion of the carotid and subclavian arteries with evidence of retrograde flow into the vertebral artery. The patient has been experiencing right arm claudication as well as subclavian steal symptoms. After the stenting procedure the physician states, "An IVUS catheter was then advanced over the Grand Slam wire and used to perform IVUS imaging of the right subclavian and innominate arteries. The IVUS images revealed excellent stent deployment with adequate stent apposition and no evidence for significant residual disease. There was no evidence for disease in the innominate artery." Can we code IVUS for both the subclavian and innominate arteries (37252 and 37253)? Could you explain why or why not?