Please note this question was answered in 2018. The coding advice may or may not be outdated.
TEVAR with repair of dissecting bilateral iliacs
Question:
"Endovascular repair of penetrating ulcer of the descending thoracic aorta using a 22 French sheath on the right and a 6 French sheath on the left (33881, 75957, 34713-RT). Because of concern for dissection in the left iliac system, the physician performed abdominal aortography with iliofemoral angiography (75630-59?). Confirmed dissection and stenting of the left external and left common iliac arteries (37221/37223 or 37236/37237?). Perclose deployed right and left. Then patient markedly hypotensive, re-accessed left and right femoral arteries and performed left femoral/iliac angiogram and stented the dissecting left common femoral artery (37226-LT or 37236?). Angiography of the right iliac system revealed dissection of the right external iliac artery followed by stenting (75716-59?, 37221-RT or 37236?)." Do we use lower extremity codes for dissection or 37236-37237 (how many initial and additional codes are allowed per encounter)? How many cath placements with re-accessing both groins? Can we code for lower extremity diagnostic studies?
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