tci General Surgery Coding Alert - 2011 Issue 10

You Be the Coder: Remember Distal Vessel for Selective Catheterization

Question: Please help with coding for the following scenario:Surgeon entered the left brachial artery using a needle and Seldinger technique under fluoroscopic guidance, and catheterized the aortic arch and distally to each iliac and femoral artery. Performed arteriography using contrast, then de-catheterized, applying pressure on the brachial artery. Delaware SubscriberAnswer: The correct code is 36246 (Selective catheter placement, arterial system; initial second order abdominal, pelvic, or lower extremity artery branch, within a vascular family), because the common femoral artery is the most distal vessel catheterized in the procedure. You should append modifier 50 (Bilateral procedure) because the surgeon documented...

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