Ask Dr. Z

I am having trouble coding a primary AAA procedure, which had additional bilateral iliac stents, iCAST stent of right internal iliac, embolization. I will send dictation if needed. The history is 7.6 cm AAA and “very short common iliac arteries bilaterally”. Are the iliacs coded as extensions of the AAA procedure (34802/75952) or as primary iliac stent grafts (34900/75954)? I am leaning toward extensions of the AAA procedure, but the physician also uses a second main body device in the right iliac with failed contralateral limb in right internal iliac. Then an iCAST stent graft is used in the right internal iliac artery. Is this an extension or 37205/75960? There is a third catheter placement from the left brachial artery (additional to the bilateral aorta 36200-50). The catheter goes to the left internal iliac artery (embolization) and then is moved to the right internal iliac artery (iCAST stent). Is this reported with codes 36246 and 36246-59? The MD does angios of both internal iliac arteries (evaluation for left embolization and "identification of right int iliac branches"). Is this included in code 75952, or are additional codes used (75774)?