# Renal arteriogram



## brandyleigh23 (Mar 24, 2011)

I am having some trouble with coding this report, can someone help me?


HISTORY OF PRESENT ILLNESS: Ms. X is a pleasant woman who has had significant hypertension. She has had a recent cardiac catheterization. She is suspected of having a possible signigicant renal artery stenosis. She is referred for a diagnostic and interventional study to try to evaluate her renal status. 

PROCEDURE NOTE:  

The patient was prepped and draped in the usual manner. The right femoral artery was punctured by the Selinger technique. A 6 French sheath was intorduced in the right femoral artery. Through this sheath, a 6 French LIMA guiding catheter was used to engage the left renal artery. Selective angiogram of the left renal artery was performed. The catheter was also used to do a selective angiogram of the right renal artery.

After identification of a significant stenosis in the right renal artery, a 0.014 Spartacore wire was advanced across the stenosis in the right renal artery. Over this wire, a 4 mm x 2 cm balloon was used to dilate the lesion. Subsequent to this , a 4.5 mm x 18 mm Genesis stent was positioned across the stenosis and depolyed. 

Closing agiography was performed. 

An angiogram of the right lower extremity was also performed. The catheter was removed at that time. 


*Here are the codes I am using for this report.  Can someone please let me know if I am right or if I need to change some things... I am coding in an office for my doc that performed this at the hospital.  Thank you to anyone that can offer advice!

36245-59 x2
75724-26-59

35471
75966-26

37205
75960-26

Brandy Edmondson, CPC


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## theresa.dix@tennova.com (Mar 24, 2011)

brandyleigh23@hotmail.com said:


> I am having some trouble with coding this report, can someone help me?
> 
> 
> HISTORY OF PRESENT ILLNESS: Ms. X is a pleasant woman who has had significant hypertension. She has had a recent cardiac catheterization. She is suspected of having a possible signigicant renal artery stenosis. She is referred for a diagnostic and interventional study to try to evaluate her renal status.
> ...





Brandy,
 You did ok . But I would not code for the balloon 35471 75966. This would be included in the stent placement. Make sure to add your LT and RT onto your 36245 codes.


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## brandyleigh23 (Mar 24, 2011)

Thank you Theresa 

I know the stent is a higher valued service vs the angioplasty, but I was confused if this was just for coronary interventions.  I've only been doing Cardiology 5 months and I don't quite have everything down pat yet! I looked in the guidelines of the sections I selected my CPT codes from and it did not tell me to include or not include the angio with stent..

I appreciate you reading the report and your quick response 
I will be sure to add my LT and RT and not include the ballooning.

Brandy Edmondson, CPC


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## theresa.dix@tennova.com (Mar 25, 2011)

brandyleigh23@hotmail.com said:


> Thank you Theresa
> 
> I know the stent is a higher valued service vs the angioplasty, but I was confused if this was just for coronary interventions.  I've only been doing Cardiology 5 months and I don't quite have everything down pat yet! I looked in the guidelines of the sections I selected my CPT codes from and it did not tell me to include or not include the angio with stent..
> 
> ...



Brandy,
 Your welcome. I notice your post here and see you are learning pretty fast. It isn't easy!


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## kbazarte@yahoo.com (Mar 25, 2011)

If you can get hold of the Z-health Interventional Coding book it is incredible, I use it daily


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