# Cerebral angiogram



## todd5400 (Feb 26, 2009)

My doctor did a cerebral angiogram - the hospital has coded one way and I have coded another way  -  I want to see what someone on her says as I don't understand how the hospital got there code

1.  Right transfemoral cerebrall angio, selective left common carotid artery
2.  Selective left internal carotid artery
3.  Selective right common carotid artery
4.  Selective right internal carotid artery
5.  Selective left vetebral artery
6.  Supraselective catherization injection of MCA vessels.

The hospital has coded 
36217-RT
36217-LT
36216-LT

I have coded
36217-RT
36216-LT
36216-LT

If you agree with the hospital could you try to explain to me where they got the 36217-LT  -  they did try to explain to be but I did not understand.

Thanks in advance
Mary


----------



## MLS2 (Feb 26, 2009)

were both MCA's selected??  If right and left MCA's were selected, normal arch, femoral approach, you would have a 36216-59 for the left vertebral, 36217 for the left MCA and 36217 for the right MCA.  It would be more helpful if there was a complete report here to look at...thanks!


----------



## Maura (Feb 26, 2009)

*Cerebral Angiogram*

Mary,

I am not sure where the hospital is getting the additional 3rd order selection.  Should you be using the additional code for 2nd and 3rd order selections (36218)

Thanks!

Maura


----------



## MLS2 (Feb 26, 2009)

the 36216 is for the left vertebral, 36217 is for the one MCA off of the right internal and the other 36217 would be for the MCA off of the left internal.  they're all separate families (unless this is a bovine arch or something)


----------



## todd5400 (Feb 26, 2009)

Here is the report
Using micropuncture the right common femoral artery was accessed. A catheter was navigated into the LCCA with DS angiography. The catheter was advanced in the ICA with DS angiography. The catheter was removed and now we are going to the RCCA.  DS angiography. The catheter was advanced into the ICA. DS angiography.

The catheter was removed and navigated into the LVA.  DS angriography.

Once this was accomplished a catheter was navigated into the LICA. Using road mapping technique a guidewire into the MCA vessel.  The occluded vessel was identified and the catheter was navigated through the occlusion.

I hope this is enough information to make this more clear.  

Thank you so much for all your help and assistance.  Obviously, I am still learning about these.

Mary


----------



## MLS2 (Mar 2, 2009)

I would do a 36216-59-51 for the left vertebral, 36217 for the left MCA, and a 36217 for the right internal.

hope this helps


----------



## todd5400 (Mar 3, 2009)

Thank you so much for your assistance.  I understand how they got this!!
Mary


----------

