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Percutaneous Transmural arterial bypass with cpt 35371, 37221.

Date: Apr 29, 2024

Question:

How do you code for this procedure described below:

Completion of bilateral common femoral endarterectomies were done. Next a rt percutaneous transmural arterial bypass. Rt post tibial vein was accessed and a mirco-puncture kit was upsized to 6Fr sheath. A venogram was performed which demonstrated adequate caliber vein and bifurcated femoral venous system. A 8Fr sheath was used up/over the bifurcation using a support wire and Endo cross device was advanced into the SFA >than 3 cm beyond the origin of the profunda femoris. A snare was advanced up the femoral vein to the site of venous entry. The crossing device was deployed and wire advanced slowly retracting the needle with wire snared once within the venous lumen. Crossing device was advanced after ballooning the proximal anastomosis with 4 mm balloon. A rt LE angiogram was done to allow superposition of popliteal reconstitution and crossing catheter which was used to deploy needle and wire advanced to intra-arterial access. Lumen placement of wire and device were removed.

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