Ask Dr. Z

Hospice patient with malignant melanoma of RT thigh and inguinal lymph node that has eroded thru skin causing acute blood loss anemia. Taken to the OR for debridement, epinephrine injection, and compression packing. Patient wants intervention if indicated for bleed, but does not want any further oncologic treatments. Two days later, due to continued bleed, transferred to our hospital for angiography and IR intervention. Two feeding branches arising from the RT SFA are selected and embolized with microspheres. We are on the fence with this one, as it is the first time we have encountered a severely bleeding tumor. Should the embolization be coded as 37243 because a tumor is treated; or 37244 because the stated indication is bleeding?