Atherectomy and stent placement in Iliac territory

May 18, 2017

Question:

"Patient with kissing stents with findings of dense calcification in the infrarenal aorta with mild progressive narrowing in its mid-portion, then abrupt occlusion of a right-sided aortic stent 3 cm proximal to aortoiliac bifurcation, occlusion of right CIA, EIA stents and native femoral artery. Atherectomy of right CFA, then EIA/CIA stents, then finally distal aortic stent and native aorta. Post atherectomy, angioplasties of iliofemoral and aortic segments were followed by re-lining the occluded stents with new Omni-Link Elite stents: 6 x 59 mm in aorta, 6 x 59 in right CIA, 6 x 39 in right EIA." Can we capture code 0238T as well as stent placement in the CIA/EIA even though no reference is made to the "intent" for the atherectomy being to fully treat the stenosis and outcome being unsuccesful with reason of additional stent placements (re-lining of existing stents)? Aortic stent segment looks to be the right iliac "kissing" stent extending into the aorta, which would be included in the CIA stent code(?). Can we capture the native atherectomy additionally with code 0236T? 

Question ID: 9200
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