# Digital Subtraction Angio of Renals



## AshleyMartin (Oct 19, 2011)

I am not sure how to code for DSA of renals. 

Procedures: R/LHC, coronaries, left ventriculogram, aortic root angiogram and digital subtraction angiogram of the renals.

The report in summary:

...Swanz-Ganz catheter was advanced to the right heart, where pressures were recorded. Cardiac output was determined using the thermodilation method. A 6-French JL-4 was then advanced to the ascending aorta, cannulating the left coronary ostium where angiograms were obtained in multiple projections. This was then exchanged for a no-torque right, which was used to cannulatethe right coronary ostium where angiograms were obtained in multiple projections. This was then exchanged for a 6-French angled pigtail which was advanced to the left ventricle and withdrawn to the aortic root, where an LV-gram and aortic root angiogram were obtained. *A pigtail was brought down to the abdomen where DSA of the renals was obtained.*

Results:
RHC: R atrial pressure 20. RV 16/24. PA 59/29 with mean of 42. Wedge pressure 28. Cardiac output 5.2. Cardiac index 3.1. Left ventricular end-diastolic pressure 30.

LV-gram: revealed hyperdynamic left ventricle greater than 75% with elevated end-diastolic pressure of 30. No MR. Aortic root normal. There was about 2 to 3+ AI noted. The left ventricle was not dilated. 

Renal arteries revealed normal renals and mild disease of the infrarenal aorta.

(Report goes on to describe findings of coronary angio)

*Here is what I have: 93460-26; 93567

How do I code the digital subtraction angio of the renals??*

Thanks for all your help!


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## donnajrichmond (Oct 19, 2011)

The DSA part doesn't affect coding - it means digital subtraction angiogram.  This is just a non-selective renal angiogram done at the time of a heart cath, so code G0275. 

(many years ago DSA did affect coding because it was a process done in the darkroom and so was coded separately, now DSA is just done with a flip of the switch)


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