Femoral and popliteal angioplasty in the same leg

How do I bill for a femoral and popliteal angioplasty in the same leg? The CPT code says “femoral-popliteal”, does that mean I can only report 35474 once?

Answer:
That depends!  If the lesion treated is a short, continuous lesion briding both vessels, a single code (35474) would be reported.  If however, angioplasties are performed on two separate and distinct lesions, for example, proximal superficial femoral and distal popliteal lesions, report 35474, and 35474-59, to indicate that two separate lesions in two separate vessels were treated.  Documentation should support the diagnostic findings and the separate location of each lesion treated. In August 2006 CPT Assistant stated “Since the inception of component coding for interventional radiology procedures, the femoral and popliteal arteries have been considered two distinct vessels. If there are distinct lesions found in both the femoral and popliteal arteries and each lesion is treated separately with transluminal balloon angioplasty, CPT code 35474 would be reported twice”.

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