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Aorto-iliac pseudoaneurysm w/right iliac stenosis

Date: Nov 28, 2022

Question:

Patient presents w/bilateral LE claudication and an aortogram w/ileo-fem runoff finding of a distal aortic pseudoaneurysm in combination w/a RT iliac pseudoaneurysm along w/a significant stenosis in the RT CIA estimated at 75% w/IVUS. To avoid possible rupture/perforation of the aortic pseudoaneurysm if only treating the CIA lesions (no findings are documented for the LT CIA), the provider deployed an 11mm x 29 VBX stent into the distal aorta to cover the pseudoaneurysm. He then advanced kissing stents into the bilateral CIA lesions to reconstruct the aortic bifurcation. Since the provider treated both an aneurysm and stenosis in the same vessel (RT CIA) would we look to capturing the kissing stents (37221-50) as the primary procedure? Or would this be considered an aneurysm repair instead and if so what would be the code option since individual stents rather than an endograft (i.e 34705) was being used? Your guidance is greatly appreciated.

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