Ask Dr. Z

Documentation shows both a diagnostic extremity venogram and venacavagram, as well as IVUS of the external iliac, common iliac, and vena cava. Can both be coded together? Also, he states a stent is placed across the external iliac, common iliac, and vena cava. The vena cava is normal, so I am thinking it's a bridging stent and to code only the stent for one common iliac vessel; although, he says he starts to see narrowing in the external iliac. "Duplex US to puncture the greater saphenous vein at the knee antegrade to place 10 French sheath. Catheter into the femoral vein, venogram with digitlal subtract tech fluoro contrast showed normal anatomy. Vena cava looked patent. IVUS up the femoral vein into the external iliac vein and started to notice some narrowing then in common iliac vein narrowing going down to 4 mm. Vena cava normal at 18 mm. Wall stent placed 12 x 90 into vena cava across common iliac vein into external iliac vein. IVUS shows resolution of narrowing."