Ask Dr. Z

Is Rotarex atherectomy performed of occluded iliac stents (0238T) billable, or this only billable when performed on the native vessel?

"At this point we turned our attention to the left groin and accessed the CFA with micropuncture kit and ultrasound, placed a PerClose, and then placed an 8 French sheath into the left external iliac artery. Heparin was given. Using a Bernstein catheter and stiff 035 wire, we were able to cross both occluded iliac arteries. We used IVUS to size vessels (common and external iliacs, bilateral) and confirm that we remained inside each common iliac stent. Next, after upsizing both sheaths to longer 8 French sheaths, over an 018 wire, we performed rotorex atheterectomy of the occluded left iliac stent followed by the right. We then performed 8 mm POBA followed by placement of new kissing 8 x 79 mm VBX stents in bilateral common iliac arteries, extending each 15 mm cephalad and 5mm caudad from prior stents."