# Peripheral angiogram



## cardiology101 (Jun 28, 2011)

Another new one....Need help coding

PROCEDURE:  PERIPHERAL ANGIOGRAM.

DESCRIPTION PROCEDURE:  Adequate IV sedation.  Lidocaine into right groin.  Seldinger
                                          technique 6 french sheath placed in common femoral artery
                                          w.o complications.  Exchanges done over wire, first pigtail
                                          place din  aorta and aortogram was performed of renal
                                          and infrarenal aorta.  Pigtail pulled back and  nonselective
                                          bollus chase method used to perform angiograms of both
                                          legs.  Selective angiogram of left leg perfromed using a VS
                                          catheter to engage left common iliac.  Microcatheter was 
                                          placed and selective angiograms of common femoral as well
                                          as popliteal were performed w/ microcatheter as distal
                                          as the distal SFA.

PROCEDURES DONE:    AORTOBIFEMORAL ANGIOGRAM W. NONSELECTIVE ANGIOGRAM
                                  BOTH LEGS

                                 SELECTIVE ANGIOGRAM L/LEG W/SELECTIVE ANGIOGRAM OF
                                 FEMORAL POPLITEAL BYPASS GRAFT W/CATHETER IN LEFT
                                 BYPASS GRAFT.

                                 PTCA/ANGIOPLASTY OF PROXIMAL LESION OF FEMORAL
                                 POPLITEAL BYPASS

                                 PTCA/ANGIOPLASTY OF PROXIMAL 70% OCCULSION OF
                                 POPLITEAL ARTERY, LEFT.

INTERVENTIONAL PROCEDURE/ANATOMY:  Aortogram demonstrated patent bilateral
                                                               renal arteries 40-50% proximal l/renal
                                                               stenosis, bilateral access revealerenal
                                                               artery supplying lower lobe which is free
                                                               of disease.  Infrrenal aorta mild disease.
                                                               It bifurcates into common ilian system
                                                               bilaterally.  On the right, right common
                                                               bifurcates into common iliac bilaterally.
                                                               Right internal ilian has ostia 90% lesion.
                                                              RIght external ilian is patent w/mild disease.
                                                              Right SFA occluded and fills retrograde.  No
                                                              bypass graft was bisulized.  Extensive
                                                              collateralization form deep system and
                                                              supplies below knee amputation.  Left side
                                                              left common iliac is patent.  Left external
                                                              and internal iliac are patent.  Left SFA is
                                                              occluded and has a fem pop bypass graft,
                                                              which retrograde fills distal SFA.  The
                                                              promal/ostial portion of the fem pop bypass
                                                              graft has eccentric 80% lesion.  Popliteal has
                                                              two sequential lesions a proximal 70-80%
                                                             lesion followed by more distal 50% lesion.
                                                             Only one vessel runoff of the infropopliteal
                                                             region w/anterior tibial which supplies the foot.
                                                             Proximal 70% lesion in the anterior tibial, small
                                                             vessel.  Posterior tibial and the tibial peroneal
                                                            peroneal trunk is occluded.  Extensive
                                                            collateralization.

As always your help is greatly appreciate.


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## cardiology101 (Jul 12, 2011)

*peripheral angiogram*

Is there anybody out there that can help me with this?


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## Jim Pawloski (Jul 12, 2011)

cardiology101 said:


> Another new one....Need help coding
> 
> PROCEDURE:  PERIPHERAL ANGIOGRAM.
> 
> ...



36247,75625,75716,75774
HTH,
Jim Pawloski, CIRCC


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