ZHealth Coding Newsletter - October 2013
Q & A with Dr. David Zielske
Question: Renal snorkel stents with aorto-uniiliac prosthesis
Dr. Z, I appreciate your insight on the more complex AAA coding scenarios (using Category III CPT codes 0078T, 0079T for fenestrated modular bifurcated prosthesis). However, for the aorto-uniiliac prosthesis (34805) with renal snorkel stents, should the conventional stent codes 37205/37206 be used (with catheter placement code 36245 and stent RS&I)? Op note:
PREOPERATIVE DIAGNOSIS: Abdominal aortic aneurysm. Left internal iliac artery aneurysm. Bilateral common iliac artery aneurysm, complex anatomy. POSTOPERATIVE DIAGNOSIS: Abdominal aortic aneurysm. Left internal iliac artery aneurysm. Bilateral common iliac artery aneurysm, complex anatomy. OPERATION PERFORMED: Complex endovascular aneurysm repair with an aorto uni right iliac Medtronic Endurant device with coil embolization, left internal iliac artery aneurysm. Plug Medtronic occluder device, left common iliac artery, with additional coils placed. Right-to-left femoral-femoral bypass, bilateral renal artery covered stents in a "snorkel" technique and intravascular ultrasound.
