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?

Answer:

The dorsalis pedis artery is the distal continuation of the anterior tibial artery. There are only three tibial/peroneal vessels for CPT coding purposes: the anterior tibial, posterior tibial, and peroneal arteries. The tibial/peroneal trunk is part of any distal intervention in the posterior tibial and peroneal arteries. The anterior tibial artery takes off prior to the tibial/peroneal trunk and is the third “tibial” vessel. The distal arterial continuation into the feet is just part of one of these three vessels. There is no additional procedure billable in the case described. 

IF the only procedure performed was in the dorsalis pedis, it is an intervention in the anterior tibial artery distribution and would be coded as such. Interventions in the AT and the dorsalis pedis artery are additive into a single code (e.g., atherectomy in the DP and stent in the AT = stent with atherectomy in the anterior tibial distribution).