Ask Dr. Z

Arteriogram revealed 100% occluded LSFA and LPOP artery. IVUS was performed in the LSFA, LPOP, LTP/P arteries. IVUS revealed 100% occluded LSFA and the proximal part of LPOP but the mid to distal part of the popliteal artery, TP/P arteries were widely patent. Provider wants to bill 37252 and 37253 x 3. If I have read your previous answer correctly I believe only one may be billed. Also, can you explain what you mean by pullback when it comes to IVUS? I understand that a guiding shot cannot be billed for, but in question ID 8925 it is stated routine pullback is one. If there are specific lesions being evaluated, then code per vessel. So, in my example would that be considered a pullback or evaluation? The arteriogram already confirmed the occlusion, so I want to say only one can be coded. Please provide clarification.