# L1 lumbar artery, L2 lumbar artery, L2 lumbar artery



## Shirleybala (Jul 6, 2009)

Help to code this report

       History: 55-year-old with going right retroperitoneal hematoma
       status-post embolization of the active bleed in the distribution
       of the right renal artery presents with apparent recurrent
       bleeding.

       Procedure and findings: After obtaining informed consent,
       anesthesia was established by the anesthesiologist.  Continuous
       physiologic monitoring of arterial blood pressure, pulse and
       oxygen saturation was performed throughout the the procedure.

       The patient was placed supine on the fluoroscopic table and the
       right groin region was prepped and draped in a sterile fashion.
       The right common femoral artery was accessed via Seldinger
       technique, and a 5-French angiographic sheath was placed for
       vascular access. A 5 French  SOS selective catheter was used to
       catheterize the right renal artery. Selective angiography with the
       catheter positioned in the origin of the right renal artery
       demonstrated opacification of the upper pole of the right kidney.
       No active extravasation was demonstrated.  Using coaxial technique
       a 3 French micro-catheter was advanced into the distal right renal
       artery. Angiography demonstrated no active extravasation in the
       distribution of the terminal branches of the right renal artery in
       the vicinity of the in situ percutaneous nephrostomy where coil
       embolization was performed previously. Subsequently, selective and
       subselective catheterizations of the second renal artery supplying
       the lower pole, T12 intercostal artery, L1 lumbar artery, L2
       lumbar artery, L2 lumbar artery, phrenic artery, capsular artery,
       bilateral internal iliac arteries were performed. No active
       extravasation was demonstrated in the distributions of the above
       arteries. No embolization was performed.  The sheath was removed
       followed by manual compression until hemostasis.

       IMPRESSION:

       No active extravasation was demonstrated by subselective
       angiography of the upper pole right renal artery, lower pole renal
       artery, T12 intercostal artery, L1 lumbar artery, L2 lumbar
       artery, L2 lumbar artery, phrenic artery, capsular artery,
       bilateral internal iliac arteries.

       No embolization was performed.


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## dpeoples (Jul 8, 2009)

Shirleybala said:


> Help to code this report
> 
> History: 55-year-old with going right retroperitoneal hematoma
> status-post embolization of the active bleed in the distribution
> ...



The document is a little vague but here goes...

36215 T12  - 75705
36246 Lt Internal Iliac - 75736
36246 Capsular Artery (from Phrenic or Renal)- 75774
36245 2nd renal  - 75774
36245 Phrenic/Renal (whichever did not lead to capsular)-75724 or 75726
36245 Rt Internal Iliac - 75736
36245 L1 - 75705
36245 L2 - 75705
36245 L3 - 75705

Use modifiers 59/76 depending on payor.


I hope this helps.


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