# Brachiocephalic arteriogram



## Shirleybala (Jan 7, 2009)

Hi,
How to code  S & I for Brachiocephalic arteriogram.
     The patient was prepped and draped
      appropriately and after infiltration with local anesthesia, the
      right common femoral artery was punctured with a micropuncture set
      to introduce a 5-French sheath.  Through this a 5-French
      Berenstein catheter was passed up the right innominate artery
      where an injection was performed.  The catheter was then advanced
      into the right subclavian artery and further injections performed
      in various projections and with filming down the arm.

      After  the filming and attempt was made to cross the complete
      occlusion without success.

      Findings.

      Brachiocephalic arteriogram.

      No abnormality is seen in the proximal carotid or subclavian
      arteries.

      Right subclavian arteriogram.

      There is minimal irregularity inferiorly just distal to the
      internal mammary artery.  There is complete occlusion of the
      artery with the appearance of thrombus just distal to the lateral
      thoracic artery.  Collaterals are well developed around the
      shoulder to reconstitute the brachial artery 7 cm distally.  There
      is thrombus at the origin of the lateral circumflex humeral
      artery.  Filming down the brachial artery demonstrates complete
      occlusion of the radial artery just distal to its origin.


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## MLS2 (Jan 7, 2009)

I'm thinking 75710/36216


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## bhann (Jan 7, 2009)

*brachiocephalic arteriogram*

This report reflects a unilateral extremity arteriogram from the cath placment and injection in the right innominate artery. In addition the catheter was advanced to the right subclavian artery with further injections and imaging. This would be reported with 75710 for the initial extremity arteriogram from the innominate cath placement and injection. The additional "selective" arteriogram from the cath placement and injection in the subclavian artery would be reported with 75774. The only cath placement to report is 36216 for the cath placement to the subclavian.


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## Shirleybala (Jan 9, 2009)

Thankyou


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