Ask Dr. Z

What codes are supported for billing the endovascular procedure and why?

"Ultrasound-guided cannulation right common femoral artery- Selective left leg angiogram- Left anterior tibial lithotripsy with 3 mm x 40 mm Shockwave lithotripsy balloon- Angioplasty distal left anterior tibial artery with 2 mm x 100 mm ultra verse balloon-

Operative findings:

#1. The left posterior tibial artery still patent with minor areas of disease proximally and distally. The posterior tibial goes into the foot but does not appear to supply much of any blood flow to the digits on the left foot.

#2. The anterior tibial was able to cannulated with 0.018 wire and 0.014 wire. The wires could not be advanced all the way into the foot. After treatment of the anterior tibial with 3 x 40 mm lithotripsy shockwave balloon, it was quite obvious that the lithotripsy balloon could not be advanced all the way into the foot. This was replaced with 2 mm x 100 mm balloon which once again could not be advanced across the heavily calcified and diseased distal anterior tibial artery into dorsalis pedis. The procedure was then terminated."