A: Yes. The tibioperoneal trunk is a continuation of the popliteal artery after the anterior tibial branches off. The TP trunk then branches into the posterior tibial and peroneal arteries. If an intervention is performed in the TP trunk and then in the anterior tibial artery, both may be coded since the anterior tibial does not branch from the TP trunk. However, if an intervention is performed in the TP trunk as well as in either the posterior tibial or peroneal arteries, the TP trunk intervention is bundled and not reported separately.
Q: You mentioned that IVUS cannot be reported with lower extremity revascularization codes, but I thought it could. Could you please clarify?
A: IVUS can be reported in addition to codes for lower extremity revascularization when it is used to assess the lesion to determine which intervention to use. If IVUS is used as guidance for subintimal cannulation, it is not separately reportable.
Q: Can you clarify what constitutes occlusive disease?
A: Occlusive disease typically refers to atherosclerosis, or plaque formation within the arteries, which leads to narrowing and eventually occlusion. Although arterial dissection and thrombus formation can also occlude vessels, they are not coded as occlusive disease in CPT.
Kristi Pollard, RHIT, CCS, CPC, CIRCC, AHIMA-Approved ICD-10-CM/PCS Trainer
Kristi also performs DRG and APC audits and is known for her vast knowledge on coding vascular interventional radiology procedures. Kristi has an extensive background in coding education and consulting and is a national speakers on topics related to ICD-10 and CPT coding as well as code-based reimbursement.