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

Stent graft placement for a lower extremity endoleak

A patient status post deep venous arterialization (DVA), a procedure in which arterial blood is shunted to the deep veins, presented with an endoleak at the proximal anastomosis at the left posterior tibial artery/vein. A micropuncture needle was advanced into the left superficial femoral artery and a wire was advanced distally through the proximal arterial anastomosis into the pre-existing deep venous arterial stent graft. Angiography was performed and stent grafting of the proximal posterior tibial artery was performed over the wire with insertion of a heparin-coated stent graft. After post-balloon dilation of the vessel, a quick cross catheter was advanced into the distal posterior tibial vein and an extension of a pre-existing venous stent with a heparin-coated stent graft was performed for stenosis in the valves. What are the correct codes to capture the stent graft placement for the endoleak at the proximal anastomosis at the left posterior tibial artery/vein status post DVA? ...

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