# help with reports PLEASE



## efuhrmann (Aug 19, 2009)

Sorry if my request posts twice.  Can anyone share their thoughts on coding the following:
 Day 1:    a) Pelvic aortogram with right lower extremity runoff in an up-and-over fashion.
             b) Insertion of a multi-port lytic drip catheter, 5 French size.
             c) Injections of local tissue plasminogen activator.
  post-procedural diag:  acute popliteal occlusion
"A micropuncture kit was used to cannulate the left femoral artery.  A guidewire and Omni Flush catheter were placed in the inferior portion of the abdominal aorta.  Under fluoroscopic guidance, as well as a power injector, pictures of the distal aorta and bilater pelvigram were performed, were within normal limits but somewhat tortuous.  In an up and down fashion the glide, followed by an Omni Flush catheter, were done with some difficulty due to the tortuosity.  Finally the right leg films were performed in sequence under power injection.  He was found to have an acute popliteal occlusion.  This lesion was crossed after tissue plasminogen activator was instilled at the occlusion, 2 mg.  A wire was placed through the lesion and into the posterior tibial artery of an 0.035 nature, just in the mid early portion of the tibial artery, which was rapid-exchanged for the multi-port microcatheter of 5 French, 90 cm long, with 10 cm of side-port ability.  At this point, the occlusion wire was placed through this...The payient will be dripped with lytics at 1 mg per hour overnight ...
Please not that the radiographic readings were done by me, and he was found to have a normal distal aorta, bilateral iliacs as well as normal superficial femoral artery on the right."

    Day 2    a) Bilateral lower extremity arteriogram
   post-procedure diag:  s/p overnight lytic therapy, ischemic right lower extremity.

Day 6:    S/P fasciotomy by orthopedics on Day 4
             a)  I & D left thigh lateral compartment with PulsaVac irrigation and muscle debridement, then delayed primary closure.
Thanks to anyone that will help.


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## dpeoples (Aug 19, 2009)

efuhrmann said:


> Sorry if my request posts twice.  Can anyone share their thoughts on coding the following:
> Day 1:    a) Pelvic aortogram with right lower extremity runoff in an up-and-over fashion.
> b) Insertion of a multi-port lytic drip catheter, 5 French size.
> c) Injections of local tissue plasminogen activator.
> ...



Here goes:

37201/75896 for infusion thereapy
36247 for infusion catheter in RT Popliteal Artery or beyond
75625 for aortogram
75710 for RT Lower Extremity Angiogram

As for the ICD9, 444.21 unless the occlusion is caused by arteriosclerotic plaque, in which case 440.20   

HTH


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## efuhrmann (Aug 19, 2009)

thank you


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