CPT code for PTA in external iliac and common femoral artery on the same side

Question: Which angioplasty codes should be reported when percutaneous transluminal angioplasty is performed in the external iliac artery and the common femoral artery on the same side during the same session?

Answer:
The external iliac and common femoral arteries are separate vessels. Any necessary angioplasty within a
single vessel is reported with only one procedural angioplasty and one radiological supervision and interpretation angioplasty code. If there are distinctly separate lesions in the external iliac artery and in the common femoral artery segments, and each is separately treated, both would be coded. Therefore, code 35473, Transluminal balloon angioplasty, percutaneous; iliac, should be reported in addition to
code 75962, Transluminal balloon angioplasty, peripheral artery, radiological supervision and interpretation, for the external iliac therapy. For the common femoral angioplasty, code 35474, Transluminal balloon angioplasty, percutaneous; femoral-popliteal, should be reported in addition to code 75964, Transluminal balloon angioplasty, each additional peripheral artery, radiological supervision and interpretation
(List separately in addition to code for primary procedure).

If angioplasty is performed through an already established access (for a preceding diagnostic or therapeutic procedure), the selective catheterization code should be reported only once. If new or additional access is required, this new additional catheterization (eg, 36140-36247) should be reported in addition to the angioplasty procedure performed.

Angioplasty is generally reported only once per vessel treated. If there are multiple lesions treated within a
single vessel, all of which are treated with angioplasty, only one angioplasty code is reported. Additionally, if
there is one contiguous lesion that bridges more than one vessel, treated with angioplasty, this is considered one angioplasty service and only one angioplasty code is reported. In this case, one would code for the vessel that is dominantly involved and treated. If there are distinct lesions found in two distinct arteries and each lesion is treated separately with transluminal balloon angioplasty, each procedure is separately reportable (eg, superficial femoral and popliteal arteries).

If a second angioplasty is performed in a separate arterial vessel, the radiological supervision and interpretation for the second angioplasty is reported with add-on code 75964.


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