# abdominal aortogram/Periperhal run off



## karbaker (Dec 31, 2012)

Need help coidng this one
Thanks
Karen B

PERFORMED:


1. Abdominal aortography.


2. Peripheral runoff study.





INDICATION FOR PROCEDURE:   a 47-year-old gentleman


with diabetes, vascular risk factors, known peripheral arterial disease,


presenting with worsening claudication.  The patient has abnormal


Doppler study and therefore he is referred over for abdominal


aortography and runoff study by his cardiologist, Dr. Banerjee.





DESCRIPTION OF PROCEDURE:  After appropriate explanation of the


procedure, its indications, risks and benefits, an informed consent is


obtained .  The patient is brought to the catheter


lab in fasting state.  The patient is prepped and draped in the usual


sterile fashion.  IV conscious sedation is induced using cath lab


protocol.  Left groin area is prepped and draped in the usual sterile


fashion.  It is infiltrated with approximately 10 cc of 1% lidocaine and


satisfactory local anesthesia is achieved.  Left femoral artery is


cannulated using 18 gauge needle and a 5-French pigtail catheter is


placed in the abdominal aorta.  Abdominal aortography and then


peripheral runoff study was performed using digital subtraction


angiography.  At the end of angiography, the catheter is removed, sheath


is flushed, findings are reviewed, the patient did well.





ANGIOGRAPHIC DATA:  Abdominal aortography demonstrated a normal contour,


course and caliber of abdominal aorta.  Right kidney had dual supply.


Both renal arteries were patent, abdominal aorta was patent without any


stenosis or obstruction.  There as no evidence of aortic aneurysm.





PERIPHERAL RUNOFF STUDY:  Right iliac was completely occluded at the


origin and was collateralized and reconstituted at the level of right


common femoral vessel.  Thereafter, the right superficial femoral, right


popliteal, anterior and posterior tibials were patent all the way to the


ankle.





Left lower extremity runoff study demonstrated patent left iliac in the


proximal segment.  Thereafter, there was a presence of __________ stent


that was patent.  Beyond the stent there was a high grade lesion long


segment extending all the way to the common femoral on the left side.


Left SFA was patent in the proximal and mid third of the thigh, but at


the level of __________ left SFA had a high grade lesion.  Left


popliteal was patent behind the knee and left anterior and posterior


tibials were patent all the way to the ankle.





CONCLUSIONS:  In summary, the patient demonstrates


1. Normal contour, course and caliber of abdominal aorta.


2. Patent renal vasculature.


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## donnajrichmond (Dec 31, 2012)

karbaker said:


> Need help coidng this one
> Thanks
> Karen B
> 
> ...



As documented, 36200, 75630.  If the catheter was repositioned between the aortogram and extremity study the codes could change.


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## karbaker (Dec 31, 2012)

thank you so much. I was way off.

karen


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