Ask Dr. Z

I have a case were a chemoembolization was performed in the hepatic arteries and an angioplasty was performed on the left external iliac artery. The angioplasty was not planned; stenosis was found when trying to cannulize the artery for the embolization. The problem is that I have to use codes 37243 and 37220 for two different vascular families, and due to the fact a diagnostic angiography was performed on the external iliac I have catheter placements for both areas of treatment, so codes 36247 and 36248 x 3 for the hepatic embolization and 36249 for the diagnostic angio in the external iliac. Due to code 37220, codes 36247 and 36246 both require a -59 modifier, but code 36247 overrides 36246. How do we address that so that both catheter placements are paid?