Ask Dr. Z

How would you report the following scenario for CT surgeon, IC, and vascular surgeon? The CT surgeon and the IC performed the TAVR through percutaneous femoral approach. Afterward, according to vascular op note, the patient had lack of pulses and signals in bilateral groins, so the vascular surgeon was called into the room. The vascular surgeon prepped the patient and made incisions into both groins, exposed the CFAs, removed previous Proglides, and performed bilateral CFA endarterectomies (35371-50), stented the left EIA (37221), and performed separate arteriotomy for endarterectomy of left SFA with patch (35302). For the TAVR, would you use the femoral exposure code 33362 for CT surgeon and IC? For the vascular surgeon, since both femorals were exposed, would you use modifier -52 for 35371-RT (TAVR side), 35371-LT, 37221, and 35302? Not sure how to code vascular part when they did the femoral exposure with other procedures after the TAVR. These were all done in one session but with different anesthesia.