Ask Dr. Z

"History of May-Thurner, chronic thrombus in existing iliac stent. Venography and IVUS documents only thrombus, no narrowing or stenosis. Thrombectomy and venoplasty performed. Repeat IVUS performed for the purposes of determining appropriate stent size. The chronically thrombosed left iliac stents were then relined with placement of a stent extending from the confluence of the IVC and left common iliac vein into the left external iliac vein. This was then extended with deployment of a 12 mm x 60 mm overlapping Cook venous stent extending into the left common femoral vein." 

Is it appropriate to report codes 37238 and 37239, or should only the thrombectomy be coded? Is the history of May-Thurner enough to justify the stent placements without an underlying stenosis documented? An external audit company is recommending coding 37238 and 37239. Thank you for your advice!