AHA Coding Clinic® for HCPCS - 2020 Issue 2; Ask the Editor

Bilateral intravascular ultrasound (IVUS)

A patient with stenosis of the right and left external iliac veins and right and left common iliac veins presented for treatment. Access to the vasculature was from the left common femoral vein using an up and over approach. A venogram was performed which did not correlate with the patient’s clinical picture, therefore, an intravascular ultrasound (IVUS) was performed evaluating the right and left femoral vein, the right and left common femoral vein, the right and left external iliac vein, the right and left common iliac vein and the inferior vena cava to the right atrium. The findings indicated severe stenosis in the proximal left common iliac vein, moderate stenosis in the right common iliac vein and moderate stenosis in the proximal right external iliac vein and milder moderate stenosis in the left external lilac vein, each area of stenosis was separate and distinct from the other lesions. Decision was then made to perform balloon angioplasty with one stent placed in the right common iliac vein (CIV)/external iliac vein (EIV) and one stent placed in the left (CIV)/(EIV). How many codes are assigned to capture the bilateral IVUS? ...

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