# Embolization - Written informed consent



## KRJeter (Feb 12, 2010)

I was wondering if this is coded correctly:

75710, 75736, 36246/59, 36247/59, 36248, 75894, 37204, and 75898x 3


Written informed consent was obtained. Using the micropuncture access set, the left common femoral artery. A 5 French Omni Flush catheter was advanced over an 035 guidewire and reformed in the proximal abdominal aorta. That catheter was pulled down to the level of the distal abdominal  aorta and a pelvic arteriogram was performed in the AP projection. A Bentsen guidewire was then advanced through the Omni Flush catheter into the right common and subsequently the external contralateral right iliac arterial system. Right iliac arteriogram was performed. A right internal iliac arteriogram was then performed in the AP projection. Selective right external iliac arteriogram was performed. With a 3 French microcatheter burst 3 French straight Progreat followed by a 3 French angled Renegade microcather and the use of both 018 angled and 018 double angled Glidewires, the inferior epigastic artery was selectively catherized off the distal right external iliac artery. The medial femoral circumflex branch was then selectively catherized and then a parasitized branch off the proximal aspect of the medial femoral circumflex artery was catherized. The 3 French angled Renegade catheter was advanced approximatley 2 cm into the parasitized branch and a repeat arteriogram was performed. There was dense hypervascular tumor treated with 1.5 ml of 300 to 500 micron embospheres particles under meticulous embolic technique using a negative digital subtraction road map. Repeat inferior epigastric arteriogram was performed post embolization. A more distal branch of the medial femoral circumflex was cahterized and a small area of neovascularity noted overlying the mid inferior pubic ramus was evaluated, but given occlusive catheter tip was no flow beyond the catheter tip, I elected not to pursue this small area of hypervascularity. The Renegade catheter was removed and through the diagnostic Tegtmeyer catheter, a right femoral arteriogram was performed. The profunda femoral artery was selectively cahterized and a right profunda femoral arteriorgram was performed. The lateral femoral circumflex branch was then selectively catherized and multidetector subselective embolization of this vascular distribution was performed using the 300 to 500 micron size embospheres particles to devascularize neovascularity involving the greater and lesser trocanter and intertrochanteric regions. Repeat post embolization arteriograms were performed. The common and superficial femoral circumflex branch selectively catherized with a diagnostic catheter was subselectively a parasitized branch was subsequently catherized off this vascular distribution with the 3 French Progreat microcatheter. Embolization again performed with 300 to 500 micron size embosphere particles of prominent hypervascular mass projecting over the obturator foramen. Post embolization arteriogram was performed. At the end of the procedure, the catheters were removed and hemostasis obtained using a 6 French Star-closed device. There was no procedural complications.


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## BARNABY (Feb 23, 2010)

*reply on Embolization*

I think that is correct, may want to check INS policy for modifier.


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