Ask Dr. Z

What codes should be used for endovascular reconstruction with bifurcated vascular prosthesis, bilateral common iliac artery angioplasty with balloon expandable stents? It was the same technique as an AAA repair, using the same modular bifurcated device (34803), with bilateral cutdowns, but with an atherectomy performed in the obstructed right CIA to gain access to the aorta prior to deploying the prosthesis. Additionally, bilateral balloon expandable LifeStream stents were placed, within the limbs, due to residual stenosis. However, this procedure was performed for a total occlusion of the right CIA, subtotal occlusion of the left CIA, total occlusion of the left EIA with severe and diffuse aortic obstructive disease. The patient has Leriche’s syndrome. According to the CPT book, code 34803 is exclusive to aneurysm repair. Should we use an unlisted code? I have absolutely no idea how to code this. Also, are the associated radiology services, cut-downs and catheter placements billable as with a AAA?