# IABP and Distal aortogram



## gelebelegirl (Aug 12, 2013)

Can someone assist me with coding this:

Procedure Performed:  
1. Distal aortogram
2. Insertion of intra-aortic balloon pump
3. Access right femoral artery                              

Procedure Details:
The risks, benefits, complications, treatment options, and expected outcomes were discussed with the patient and his wife. The patient and/or family concurred with the proposed plan, giving informed consent. The patient was brought to the cath lab urgently. He is known to have dye allergy but did well this week with pre-treatment. He was treated with IV Solumedrol, IV Benadryl and IV Pepcid. The patient was further sedated with Versed. The right groin was prepped and draped in the usual manner. Using the modified Seldinger access technique, a 5 French sheath was placed in the right femoral artery. A pigtail catheter was used to perform a distal aortogram. I then changed the sheath out for the 7.5 French sheath. The balloon catheter was advanced over a wire in a retrograde fashion into the thoracic aorta. The balloon pump was set at 1:1. There were no immediate complications. The patient was taken to the CCU in stable condition. 


Hemodynamic Findings:
Central aortic pressure: 91/60

I was told at one point that you could not bill the distal aortogram 75625 and IABP together 33967.  I'm not finding anything that says you can't bill together.


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## Robbin109 (Aug 15, 2013)

Dr Z's coding reference says:

If diagnostic angiography of the thoraic aorta is medically necessary prior to the IABP placement, use code 75605. If "angiography" is for guidance to safely place an IABP it is included in the procedure.

What is the medical necessity? Check with your doctor.


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