# Heart cath, aortic arch, subclavian angiogram and renal angiogram



## yayasjfp (Aug 27, 2013)

How do I code left heart catheterization, left ventriculogram, aortic arch aortogram, selective coronary angiogram, selective left subclavian angiogram, and selective renal angiogram?
 Op Note: A 6-French catheter inserted (femoral artery) percutanously  to measure central aortic and left ventricular pressures. Ventriculogram was performed in the RAO projection with contrast. Pigtail was positioned in ascending aorta and an aortic arch aortogram was performed in the LAO sequentially for 6-French catheter left 4 and right 4 Judkins diagnostic catheters. Selective angiograms of left and right coronary arteries were obtained  in multiple projections. A selective antiogram of the left subclavian artery was performed. At the completion of the case, selective angiograms, of the left and right renal arteries performed as well.

I have a second op report for Angioplasty and stenting of the left subclavian artery and need help coding this also. All done the same day as above LHC LV COR, ao arch, subclavian and renal angiograms. 
Op report: Previously placed 6-French vascular sheath in the right femoral artery was upgraded to an 8-French vascular sheath with Angiomax bolus and infusion started by peripheral IV. An 8 Judkins guide and then multipurpose guide were attempted with the 8 Judkins selecting the left subclavian better of the 2, although it over engaged in the tip crossed the lesion. In any event, BMW wire was advamced out the left subclavian artery and a 7X15 m stent was positioned and subsequently deployed in teh stenosis of the proximal left subclavian artery. Followup shot showed a good result with neglible residul. Flow was better in the nertebral with little residual 40% ostial narrowing at the takeoff of the vertebral, basically 90% narrowing in the left subclavian is reduced to 0% with a little bit of irregularity proxima to the stent.


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## Jim Pawloski (Aug 27, 2013)

yayasjfp said:


> How do I code left heart catheterization, left ventriculogram, aortic arch aortogram, selective coronary angiogram, selective left subclavian angiogram, and selective renal angiogram?
> Op Note: A 6-French catheter inserted (femoral artery) percutanously  to measure central aortic and left ventricular pressures. Ventriculogram was performed in the RAO projection with contrast. Pigtail was positioned in ascending aorta and an aortic arch aortogram was performed in the LAO sequentially for 6-French catheter left 4 and right 4 Judkins diagnostic catheters. Selective angiograms of left and right coronary arteries were obtained  in multiple projections. A selective antiogram of the left subclavian artery was performed. At the completion of the case, selective angiograms, of the left and right renal arteries performed as well.
> 
> I have a second op report for Angioplasty and stenting of the left subclavian artery and need help coding this also. All done the same day as above LHC LV COR, ao arch, subclavian and renal angiograms.
> Op report: Previously placed 6-French vascular sheath in the right femoral artery was upgraded to an 8-French vascular sheath with Angiomax bolus and infusion started by peripheral IV. An 8 Judkins guide and then multipurpose guide were attempted with the 8 Judkins selecting the left subclavian better of the 2, although it over engaged in the tip crossed the lesion. In any event, BMW wire was advamced out the left subclavian artery and a 7X15 m stent was positioned and subsequently deployed in teh stenosis of the proximal left subclavian artery. Followup shot showed a good result with neglible residul. Flow was better in the nertebral with little residual 40% ostial narrowing at the takeoff of the vertebral, basically 90% narrowing in the left subclavian is reduced to 0% with a little bit of irregularity proxima to the stent.



93458, 36215-lt-59, 75710-59 (if diagnostic angio. was not for possible LIMA graft), 37205/ 75960 for stent placement, 36252.  
HTH,
Jim Pawloski, CIRCC


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## yayasjfp (Aug 28, 2013)

Jim, Thanks for the information. 
Janie Pias, CPC-P


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