ZHealth News

ZHealth Coding Newsletter - April 2017

Apr 20, 2017 2:22:00 AM

April 2017 Q & A

Question: Left Dorsalis Pedis an Additional Artery on Left Anterior Tibial?

An angioplasty was performed on the left dorsalis pedis artery...an angioplasty with atherectomy was performed on the left anterior distal tibial artery. Is the left dorsalis pedis angioplasty an add-on to code 37229, or is it part of code 37229? Is just code 37229 reported, or 37232 and 37229?

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Posted in Free Newsletters By Sondra Dunn

ZHealth Coding Newsletter - March 2017

Mar 17, 2017 2:22:00 AM

March 2017 Q & A

Question: Treating Tibioperoneal Trunk with PTA and SFA

I have heard that it may be possible to code for an intervention in the tibioperoneal trunk in the following two scenarios: 1. It is the only vessel treated; 2. It is separately treated in addition to an intervention in the anterior tibial artery. My patient has focal stenoses of the mid and distal SFA treated with angioplasty. A patent popliteal artery. Focal high grade stenoses in the superior aspect of the tibioperoneal trunk and within the distal tibioperoneal trunk at the bifurcation of the peroneal and tibial artery. These stenoses were treated with angioplasty as well.

Can I report code 37228 for the tibioperoneal trunk in addition to the SFA angioplasty (37224)? I'm a bit confused because the CPT code book indicates the tibioperoneal trunk would be considered part of the tibial/peroneal territory, but not a separate 4th segment of vessel. Does this mean if it is the only segment of vessels in the tibial/peroneal territory it is billed? Even if another territory is billed? 


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Posted in Free Newsletters By Sondra Dunn

ZHealth Coding Newsletter - March 2016

Mar 30, 2016 2:20:00 PM

March 2016 Q & A

Question: Angioplasty or Primary Thrombectomy with No Stenosis Documented

Patient is on Day 2 of lower extremity arterial thrombolysis with EKOS catheter. The patient was placed on the angio table and the catheter was injected showing significant residual heavy clot burden. The physician ballooned the thrombus in the anterior tibial, posterior tibial and peroneal arteries with a 3mm balloon, then used an aspiration catheter in each vessel post ballooning due to loose clot seen within these vessels. There is no physician documentation of any underlying anatomical stenosis in these vessels. Thrombolysis was restarted with the EKOS catheter and sent to the floor for overnight monitoring. On Day 3, the patient is brought back for AngioJet thrombectomy, repeat ballooning of the peroneal along with thrombolytic spray through the AngioJet for 20 min. This is repeated in the posterior tibial artery. Follow-up angiography demonstrates a flow limiting dissection requiring stent placement.

Day 2 was coded as ...

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Posted in Free Newsletters By Sondra Dunn

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