Ask Dr. Z

Would appreciate assistance on the following: The patient had extensive DVT in bilateral iliac, femoral, and popliteal veins as well as the IVC. Three infusion catheters were placed (one in each lower extremity and one in the IVC). The next day, followup angios were performed through each of the catheters. Based on findings of extensive residual filling defects, mechanical thrombectomy (Angiojet) was performed in both lower extremities. Additional venograms continued to show extensive residual clots, so an angioplasty balloon was used to macerate the clots. We understand that we would code only 75898 1x for the followup angios. However, since additional intervention was performed in both extremities, are we able to code for catheter placement for the mechanical thrombectomy? Would 36005 with a modifer 52 be appropriate? Also, use of an angioplasty balloon to macerate the clots is included in 37187 and not coded separately as 35476, correct? Thank you.