Ask Dr. Z

I have a physician who wants to charge for three arterial thrombectomies. Here is his documentation: "We then attempted AngioJet with a thrombectomy catheter, which did resolve about 30% of the clot. We then pulse sprayed 50 of the 100 ml, so approximately 10 mg of tPA, and let this dwell for approximately 15 minutes. Angiography demonstrated resolution of clot within the left popliteal. There was flow into the left anterior tibial, but again, no flow into the left posterior tibial or peroneal. CONCLUSION: 1. Severe thrombotic occlusion of the left popliteal, which was 100% occluded. There was no visualization of any of the three infrapopliteal vessels. 2. There is suboptimal mechanical thrombectomy of the left popliteal and tibioperoneal clot. An AngioJet thrombectomy with thrombolysis with pulse spray was performed of the left popliteal, left tibioperoneal trunk, and left anterior tibial arteries." So the question is, do we charge for codes 37184 and 37185 x 2? Or just report code 37184?