# How to crack this scenario



## vikas.maheshwari (Oct 29, 2009)

My physician perform,

Left femoral arteriography and right femoral arteriography both are severely diseased. Left subclavian angiography, Left internal mammary artery angiography, Left coronary artery angiography, AORTIC CORONARY SAPHENOUS VEIN GRAFT ANGIOGRAPHY: 

i think that 

93510, 93545, 93556, 93539 are the only codes for this angiogram can anybody help me on this matter.


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## dpeoples (Oct 29, 2009)

Vikas Maheshwari said:


> My physician perform,
> 
> Left femoral arteriography and right femoral arteriography both are severely diseased. Left subclavian angiography, Left internal mammary artery angiography, Left coronary artery angiography, AORTIC CORONARY SAPHENOUS VEIN GRAFT ANGIOGRAPHY:
> 
> ...



Can you provide the actual report?


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## vikas.maheshwari (Oct 30, 2009)

RIGHT FEMORAL ANGIOGRAPHY: The right common femoral artery is heavily calcified and seve\ely
diseased. The shpth oritera the rinht nnmmnn femnml There is runoff into the su~erficiafle moral and
profunda fernoris.

LEFT FEMORAL ARTERIOGRAPHY: The left common femoral artery is severely diseased and h&vily
calcified. The sheath enters the left common femoral. There is good runoff into the superficial femoral
and profunda fernoris.

LEFT SUBCLAVIAN ANGIOGRAPHY: There is calcif~dpl aque at the origin of the left subclavian, but
there does not appear to be any obstructive stenosis. Pressure pullback was performed across this area
and the pressure in the subclavian and the pressure in the left internal mammary artery started at 95 to
100 systolic, and back in the aorta was 112 systolic and maximum gradient was in the range of 12-15
mmHg peak gradient.
LEFT INTERNAL MAMMARY ARTERY ANGIOGRAPHY: Left internal mammary artery appeared
smooth walled, but was small in caliber, only approximately 2 mm in luminal diameter. It did reach down
to the level of the diaphragm.
LEFT CORONARY ARTERIOGRAPHY: The left coronary is highly calcified and severely diseased.
There is an 80% to 90% ostial left main coronary stehosis, which is heavily calcified. There is flow into
the left circumflex and then up the bypass graft back close to the origin of the bypass graft in the aorta,
where it is anastomosed to another limb of the grafl, which then feeds down to the LAD.
AORTIC CORONARY SAPHENOUS VEIN GRAFT ANGIOGRAPHY: The bypass graft to the LAD and
obtuse marginal is totally occluded at the aorta.


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## dpeoples (Oct 30, 2009)

Vikas Maheshwari said:


> RIGHT FEMORAL ANGIOGRAPHY: The right common femoral artery is heavily calcified and seve\ely
> diseased. The shpth oritera the rinht nnmmnn femnml There is runoff into the su~erficiafle moral and
> profunda fernoris.
> 
> ...



I would code this:
93508 (no concomitant LHC)
93539
93540
93545
93556

HTH


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## vikas.maheshwari (Oct 30, 2009)

thanks,


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## adennis (Sep 13, 2010)

*SVG (Saphenous vein graft) angiography*

My physician performed:
Left heart cath
select coronary angiography 
saphenous vein graft angiogarphy
LIMA
Stent LCX

I am familiar with everything except the saphenous vein graft angio. I know that this is different than actually grafting, but any ideas how to code for the angio?

Thanks,
Amber


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## Hari Prasadh (Sep 14, 2010)

Amber,

I would code 

92980-LC (LCX Stent)
93510 (Lt Heart Cath)
93539 (Angiography of Lima)
93540 (Angiography of Venous Graft)
93545 (Coronary angiography)
93556 (If S&I done of native coronary, arterial and venous angiographies)

Harish, CCS, CPC


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## adennis (Sep 15, 2010)

Thank you very much!!


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