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Please note this question was answered in 2010. The coding advice may or may not be outdated.

Date: Aug 18, 2010

Question:

Hi-- I need help with a surgery my provider performed on an extracranial right internal carotid artery pseudoaneurysm. "Under roadmap conditions an Xpert device, 6 mm in diameter x 20 mm length was placed with the proximal and distal edges across the neck of the aneurysm and deployed with good coverage proximally but distally at a turn may not completely cover the distal aspect of the aneurywm. A second device 6 mm in diameter x 30 mm length was then deployed with the distal portion in the internal carotid artery distal proximal to the aneurysm with good coverage acrosss the pseudoaneurysm. Control angiograms demonstrated dramatically decreased filling in the pseudoaneurysm at this point, with patency of parent vessels." Explanation: The intent is to occlude the pseudoaneurysm, when we check the CTA in 3 months it will to see if its occluded. Whether we use a stent, coil, hammer, or nail. We can change the procedure, & add an unnecessary coil & then there is no arguement - but it then keeps us from getting a good picture on the CTA in follow-up because of artifact from the coil. Can we code an emobolization code (61624) since that is the intent or do we use one of the stent codes? 37799 since it is Medicare? Thanks for your help!

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