# Thoracic aortogram



## prabha (Aug 9, 2010)

Can we code the below procedure with

36215(left subclavian)
36215x6-59(intercostal arteries)
75705x6-26
75605-26
75710-26

 Clinical history: Patient is a 55-year-old gentleman presenting
       with hemoptysis. 

       Procedure:       
        Utilizing singlewall puncture technique the
       right common femoral artery was entered with a 21-gauge
       micropuncture needle. Utilizing change technique a 5 French
       vascular sheath was placed. A 5 french Omni Flush catheter was
       then advanced into the ascending aorta and digital subtraction
       angiography of the thoracic aorta was performed. The Omni Flush
       catheter was retracted into the descending aorta and digital
       subtraction angiography of the descending aorta was performed. No
       specific abnormal blood vessels were demonstrated on the thoracic
       aortogram. Multiple guidewires and catheter combinations were
       utilized in attempts to selectively catheterize the intercostal or
       the bronchial arteries. Selective catheterizations were not
       possible. This included the use of a McKesson catheter, US2
       catheter, 2 selective and 3 selective Omni catheter as, as well as
       a 2 and 3 Simons catheters. Partial selective catheterization
       however was achieved of several mid left-sided intercostal
       arteries which failed to demonstrate abnormal appearance.
       Selective catheterization was also performed of the left
       subclavian artery with out evidence of abnormal vessels from the
       subclavian directly or its branches.

       Interpretation:       
       Normal thoracic aortogram. Normal left subclavian angiogram.
       Partial selective catheterization accomplished of several left mid
       intercostal branches which were normal in appearance. Selective
       catheterization of the bronchial arteries not achieved. No
       interventions taken as abnormal feeding vessel to pathology not
       detected.

       Impression: Selective bronchial artery catheterization not
       achieved. Only limited imaging of several left intercostal
       branches obtained which were unremarkable in appearance. No
       abnormal vessels noted off the subclavian left artery or its
       branch vessels. No interventions taken as the abnormal vessels
       supplying pathology within the left lung was not discretely
       identified.


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