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Endograft revision and thrombectomy

Date: Mar 30, 2023

Question:

"Access into the endograft was established. Occlusion of the left graft limb within the aortic bifurcation. An aortogram was performed, demonstrating widely patent right side occluded left. Intravascular ultrasound was then undertaken to evaluate the CIA and EIA on the left side and aorta. This demonstrated compression of the graft with adjunctive presence of thrombus. Decision to proceed with intervention was made. Penumbra CATx catheter was used to undertake mechanical thrombectomy of the graft within the aorta and in the iliac artery. This significant amount of thrombus was removed. Revision of the endograft repair here was undertaken with VBX stent with deployment from the aortic bifurcation and reaching just close to the end of the graft. The contralateral limb was protected with a 10 mm balloon inflated opposing leg."

Provider wants to bill codes 37220, 34710, 37184, and 37185. Could you advise on correct coding for this scenario? I'm not sure about 37220 and 34710 together.

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