Ask Dr. Z

Hello, During an AV fistula intervention the radiologist treats a an occlution from the axillary vein which extends to the innominate with angioplasty and Stent can i code two angioplasty and two Stent deployment. I knowt that the lesion in continues but i am in two different zones. Below i have included an example. Thank and Happy HOLIDAYS !!!!! ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Digital subtraction fistulography was performed from the upper arm venous outflow to the heart. The micropuncture catheter was exchanged over an 035 wire for a 7-French vascular sheath. The axillary and subclavian veins were angioplastied with an 8-mm and 10-mm balloons after the lesion have been crossed with a 035 Glidewire and catheter. Upon crossing the occlusion contrast was injected through the catheter to confirm intravenous position. The subclavian vein/innominate venous junction was angioplastied with 8 and 12-mm balloons. As flow through this occlusion could not be reestablished, the occluded segment from the axillary vein to the innominate vein was stented with a 10 mm x 6 cm Zilver stent and a 12 mm x 4 cm Zilver stent, the larger of the two stents extending through the smaller 10-mm stent and into the innominate vein.