Ask Dr. Z

Help please! I'm coming up with codes 37221 and 35656... do you agree? "We did a longitudinal arteriotomy through the profunda into the common femoral patch, and noticed a very tight stenosis of the origin of the profunda artery. We ran a 4 French Fogarty embolectomy catheter up the iliacs, removed a large amount of thrombus, and re-established some flow back into the femoral. A 7 French sheath was placed into the femoral, and an angiogram to look at the aorta and iliacs showed a long segment left iliac occlusion. We placed an iCAST stent 8 mm diameter, 38 mm length, at the origin of the common iliac on the left, and then angioplastied the remainder of the iliac common femoral with an 8 mm balloon. We then sewed a Hemashield patch over the profunda for the profundoplasty portion. Left lower extremity angiogram showed reconstitution of left popliteal artery above the knee with two-vessel runoff to foot. There wasn't good pulse to foot, so we did a left fem-pop bypass. There was still narrowing at the anastomosis, so we ballooned it."