# Spinal Angiography



## maav0300 (Jun 4, 2012)

New to spinal angiography.   Wondering if this is correct coding for the procedure below.

75705	26	
75705	26	59   x 17
36215	59    x 	16	
36217		
36217	59	
Procedure note : Informed consent was obtained from the patient after explaining risks 
and benefits of the procedure. The risks of the procedure included 
infection, vascular damage, paraplegia and death. All the questions 
were answered. The consent was placed in the patient's chart. She 
was brought to the angiography suite and both groins were draped and 
prepped in the usual sterile fashion. General anesthesia was given. 
Lidocaine 1% was used for local anesthetic. 
Using an 18 gauge needle, access was obtained into right common 
femoral artery. A 5 French vascular sheath was inserted using the 
Seldinger technique into the artery. A 5 French Chung 2 (2.5 cm) 
catheter was advanced over the 0.035 Glidewire into aortic arch and 
its curve was reformed. The catheter was then used for selective 
catheterization of the arteries starting from supreme intercostal 
level down to T8 intercostal arteries on both sides. Angiograms were obtained in 
various projections.
FINDINGS: 
Onyx cast visible from prior embolization of the right T5 AND T6 feeders.
Right supreme intercostal (AP view): No feeder identified. T1-T4 intercostal arteries are opacified.
Left supreme intercostal (AP view): No feeder identified. T1 -T5 intercostal arteries are opacified
Right T5 intercostal artery (AP view): No feeder identified. The artery is markedly attenuated due to previous embolization.
Right T6 intercostal artery (AP view): No feeder identified.No recurrent DAVF identified. The artery is markedly attenuated due to previous embolization.
Left T6 intercostal artery (AP view): No feeder identified. 
Right T7 intercostal artery (AP view): No feeder identified. Multiple collaterals to right T6 intercostal branches are seen. No recurrent DAVF identified
Left T7 intercostal artery (AP view): No feeder identified. 
Right T8 intercostal artery (AP view): No feeder identified. The thoracic segmental anterior spinal artery is well opcified on this injection which appears normal.
Left T8 intercostal artery (AP view): No feeder identified. 
CONCLUSION: 
Spinal angiogram shows no residual dural AV fistula.


I appreciate any assistance given!

Monique Vanderhoof


----------



## donnajrichmond (Jun 4, 2012)

maav0300 said:


> New to spinal angiography.   Wondering if this is correct coding for the procedure below.
> 
> 75705	26
> 75705	26	59   x 17
> ...



I would have to go back to the doctor and ask if he selected T1-T4 bilaterally and T5 left because he doesn't have any separate findings for those vessels.  He's got "no feeder" for others, if he selected 1-4, why not document for those?  It appears to me that as documented, he imaged those from his supreme intercostal catheterizations and not from separate selections.
As documented, I would only code 36217 x 2, 36215 x 7, 75705 x 9

Donna J Richmond


----------



## dpeoples (Jun 5, 2012)

donnajrichmond said:


> I would have to go back to the doctor and ask if he selected T1-T4 bilaterally and T5 left because he doesn't have any separate findings for those vessels.  He's got "no feeder" for others, if he selected 1-4, why not document for those?  It appears to me that as documented, he imaged those from his supreme intercostal catheterizations and not from separate selections.
> As documented, I would only code 36217 x 2, 36215 x 7, 75705 x 9
> 
> Donna J Richmond



I agree with Donna, selection of bilateral T1-T4 and Lt T5 is not documented IMO.

HTH


----------



## maav0300 (Jun 6, 2012)

Thanks to both of you for your assitance.  Can anyone direct me to a good resource for spinal angiography information specificallly relating to 36215 and 36217 codes.  These were difficult for me to determine confidently.  
Again....A HUGE thanks!


----------

