Radiology Coding Alert

History: 39-year-old woman with excessive menstrual bleeding and pelvic pain

Technique: After the benefits and risks (including possible infertility) of the procedure were explained to the patient, an informed consent was obtained. The patient was given 1 gram of Anco and 60 mg Toradol IV for prophylaxis. The patient was prepped and draped in the usual sterile fashion. An injection of 1 percent lidocaine was given for local anesthesia. The right common femoral artery was then punctured using a 19-gauge single wall needle.

A 5 French Levin 1 catheter was positioned at the aortic bifurcation over an 035 Bentson guidewire and pelvic angiogram was performed. The catheter was then positioned near the origin of the left internal iliac artery. The Levin 1 catheter was exchanged for a 5 French glide catheter. The left uterine artery was selected with a Tracker 325 microcatheter with a Taper 22 wire. Embolization was performed with PVA 355-500 particles and gelfoam pledgets.

After stasis was observed, the Tracker catheter was withdrawn. Then the right uterine artery was selected* with the 5 French glide catheter, Tracker 325 micro-catheter and a Taper 22 wire, and this vessel was subsequently embolized. The catheter and wires were then removed and hemostasis at the right groin was achieved with manual compression.

Findings: The study demonstrates a large uterus with multiple fibroids. The uterine arteries are moderately
large and tortuous. They have a normal distribution. Successful bilateral embolization was achieved with 4 bottles of PVA 355-500 and gelfoam pledgets.

Impression: Successful bilateral embolization with 4 bottles of PVA 355-500 and gelfoam pledgets.

Codes assigned: Embolization CPT 37204 and CPT 75894 ;
Catheterization36247 and 75736 (assigned twice to reflect catheterization on both the right and left sides)

(* Because this report doesnt provide detail about how the right uterine artery was selected, a code cannot be assigned and reimbursement cannot be received.)