# angiogram brachial to brachial



## coding specialist (Sep 13, 2012)

Please give input for CPT code for the angiogram and radiological and ICD9:
Had AV fistula in left upper extremity placed elsewhere and has chronic ischemia of fingers on left hand. Had bypass presumably for salvge and now failure of healing.
RIGHT arm prepped and draped. Local instilled overlying right brachial vessl and via U/S vessel punctured without incident with 4-French sheath inserted. 
Manipulation of various catheters and wires, CATHETER was placed in LEFT brachial artery. Serial angiograms obtained of left upper extremity including fistula and the hand.
Findings: patient has markedly calcific brachial artery. He has a patent fistula between brachial artery and the cephalic vein at the level of the elbow which siphons off most of the blood going to the arm. A little blood goes into more distal vessels.
Impression: Patent left upper extremity arteriovenous fistula, obvious steal effect, failed previous bypass, left upper extremity, slow filling ulnar artery, digital ischemia noted-digits 4 and 5.
THanks!


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