Ask Dr. Z

How would you code this vascular embolization/occlusion scenario? Coil occlusions were done of five collateral vessels: 1) Collateral from left hepatic vein to systemic pulmonary vein; 2) Collateral from innominate vein to the area around the left mainstem bronchus/carina; 3) Collateral from left lateral thoracic artery to left lung; 4) Collateral from right bronchial artery to the right lung; 5) Collateral from right thyrocervical artery to the right apex of the heart. For surgical fields, I see right lung, left lung, heart apex, systemic pulmonary vein, and vein in area of mainstem bronchus/carina. We often report code 37242 twice for coiling of APCs on the right and left sides, but this is way past that. I can't believe we could be billing that many separate occlusion codes. What would you suggest?