amym
Guest
Is it appropriate to code this as 36200, 75716-26-59? If not, what in the notes propted you to select the code? I have not billed these in a while and just trying to get clarification. -Thanks
-- LEFT LOWER EXTREMITY VESSELS:
--
A sheath was advanced in the left femoral artery using the Seldinger
technique. An omniflush catheter was advanced across the abdominal aorta
and an aortogram was performed. Subsequently, catheter was withdrawn over
the distal aorta right above the illiac bifurcation and and runoff was
performed at this time.
PROCEDURES PERFORMED:
-- Lower Extremity Arteriogram.
RECOMMENDATIONS:
Consultation with a vascular surgeon should be obtained for surgical
opinion.
INDICATIONS: Lower extremity: claudication.
LEFT LOWER EXTREMITY VESSELS:
A sheath was advanced in the left femoral artery using the Seldinger
technique. An omniflush catheter was advanced across the abdominal aorta
and an aortogram was performed. Subsequently, catheter was withdrawn over
the distal aorta right above the illiac bifurcation and and runoff was
performed at this time. Left common iliac: The vessel was patent,
normal-sized, non-calcified, tortuous, and excessively ectatic.
Angiography showed brisk antegrade flow and no evidence of disease. This
vessel was poorly visualized. Proximal left common iliac: Angiography
showed minor luminal irregularities. Left internal iliac: The vessel was
patent, normal-sized, and non-calcified. Angiography showed no evidence of
disease. Proximal left internal iliac: Angiography showed minor luminal
irregularities. Left external iliac: The vessel was patent, normal-sized,
and non-calcified. Angiography showed no evidence of disease. Distal left
external iliac: Angiography showed minor luminal irregularities. Left
common femoral: The vessel was patent, normal-sized, and non-calcified.
Angiography showed no evidence of disease. Mid left common femoral:
Angiography showed minor luminal irregularities. Left superficial femoral:
The vessel was patent, normal-sized, and non-calcified. Angiography showed
no evidence of disease. Mid left superficial femoral: The vessel was
patent, large, mildly calcified, tortuous, and not ectatic. Angiography
showed moderate atherosclerosis. Left popliteal: The vessel was patent,
normal-sized, and non-calcified. Angiography showed no evidence of
disease. Mid left popliteal: The vessel was patent and normal-sized.
Angiography showed moderate atherosclerosis. Proximal left anterior
tibial: There was a 100 % stenosis. There was poor collateral vascular
supply. Left tibio-peroneal: There was a 100 % stenosis. There was good
collateral vascular supply. Left posterior tibial: The vessel was patent,
normal-sized, and non-calcified. Angiography showed no evidence of
disease. Proximal left posterior tibial: The vessel was normal-sized.
Angiography showed mild atherosclerosis. The vessel was supplied by
collaterals. Proximal left peroneal: There was a 100 % stenosis.
RIGHT LOWER EXTREMITY VESSELS: Proximal right common iliac: The vessel was
partially occluded and normal-sized. Angiography showed mild
atherosclerosis. Proximal right internal iliac: Angiography showed mild
atherosclerosis. Proximal right external iliac: Angiography showed mild
atherosclerosis. Distal right external iliac: The vessel was patent.
Proximal right common femoral: Angiography showed mild atherosclerosis.
Proximal right superficial femoral: There was a 100 % stenosis. Proximal
right deep femoral: Angiography showed mild atherosclerosis. Proximal
right anterior tibial: There was a discrete 100 % stenosis. There was good
collateral vascular supply. Right tibio-peroneal: The vessel was occluded.
Angiography showed mild atherosclerosis. Ostial right posterior tibial:
There was a 100 % stenosis. Proximal right posterior tibial: Angiography
showed mild atherosclerosis. The vessel was supplied by collaterals.
PROCEDURE: The risks and alternatives of the procedures and conscious
sedation were explained to the patient and informed consent was obtained.
The patient was brought to the cath lab and placed on the table. The
planned puncture sites were prepped and draped in the usual sterile
fashion.
-- Left femoral artery access. The puncture site was infiltrated with
local anesthetic. The vessel was accessed using the modified Seldinger
technique, a wire was threaded into the vessel, and a sheath was advanced
over the wire into the vessel.
-- Lower Extremity Arteriogram..
HEMODYNAMIC TABLES
Outputs: Baseline
Outputs: -- CALCULATIONS: Age in years: 69.40
Outputs: -- CALCULATIONS: Height in cm: 185.00
Outputs: -- CALCULATIONS: Sex: Male
-- LEFT LOWER EXTREMITY VESSELS:
--
A sheath was advanced in the left femoral artery using the Seldinger
technique. An omniflush catheter was advanced across the abdominal aorta
and an aortogram was performed. Subsequently, catheter was withdrawn over
the distal aorta right above the illiac bifurcation and and runoff was
performed at this time.
PROCEDURES PERFORMED:
-- Lower Extremity Arteriogram.
RECOMMENDATIONS:
Consultation with a vascular surgeon should be obtained for surgical
opinion.
INDICATIONS: Lower extremity: claudication.
LEFT LOWER EXTREMITY VESSELS:
A sheath was advanced in the left femoral artery using the Seldinger
technique. An omniflush catheter was advanced across the abdominal aorta
and an aortogram was performed. Subsequently, catheter was withdrawn over
the distal aorta right above the illiac bifurcation and and runoff was
performed at this time. Left common iliac: The vessel was patent,
normal-sized, non-calcified, tortuous, and excessively ectatic.
Angiography showed brisk antegrade flow and no evidence of disease. This
vessel was poorly visualized. Proximal left common iliac: Angiography
showed minor luminal irregularities. Left internal iliac: The vessel was
patent, normal-sized, and non-calcified. Angiography showed no evidence of
disease. Proximal left internal iliac: Angiography showed minor luminal
irregularities. Left external iliac: The vessel was patent, normal-sized,
and non-calcified. Angiography showed no evidence of disease. Distal left
external iliac: Angiography showed minor luminal irregularities. Left
common femoral: The vessel was patent, normal-sized, and non-calcified.
Angiography showed no evidence of disease. Mid left common femoral:
Angiography showed minor luminal irregularities. Left superficial femoral:
The vessel was patent, normal-sized, and non-calcified. Angiography showed
no evidence of disease. Mid left superficial femoral: The vessel was
patent, large, mildly calcified, tortuous, and not ectatic. Angiography
showed moderate atherosclerosis. Left popliteal: The vessel was patent,
normal-sized, and non-calcified. Angiography showed no evidence of
disease. Mid left popliteal: The vessel was patent and normal-sized.
Angiography showed moderate atherosclerosis. Proximal left anterior
tibial: There was a 100 % stenosis. There was poor collateral vascular
supply. Left tibio-peroneal: There was a 100 % stenosis. There was good
collateral vascular supply. Left posterior tibial: The vessel was patent,
normal-sized, and non-calcified. Angiography showed no evidence of
disease. Proximal left posterior tibial: The vessel was normal-sized.
Angiography showed mild atherosclerosis. The vessel was supplied by
collaterals. Proximal left peroneal: There was a 100 % stenosis.
RIGHT LOWER EXTREMITY VESSELS: Proximal right common iliac: The vessel was
partially occluded and normal-sized. Angiography showed mild
atherosclerosis. Proximal right internal iliac: Angiography showed mild
atherosclerosis. Proximal right external iliac: Angiography showed mild
atherosclerosis. Distal right external iliac: The vessel was patent.
Proximal right common femoral: Angiography showed mild atherosclerosis.
Proximal right superficial femoral: There was a 100 % stenosis. Proximal
right deep femoral: Angiography showed mild atherosclerosis. Proximal
right anterior tibial: There was a discrete 100 % stenosis. There was good
collateral vascular supply. Right tibio-peroneal: The vessel was occluded.
Angiography showed mild atherosclerosis. Ostial right posterior tibial:
There was a 100 % stenosis. Proximal right posterior tibial: Angiography
showed mild atherosclerosis. The vessel was supplied by collaterals.
PROCEDURE: The risks and alternatives of the procedures and conscious
sedation were explained to the patient and informed consent was obtained.
The patient was brought to the cath lab and placed on the table. The
planned puncture sites were prepped and draped in the usual sterile
fashion.
-- Left femoral artery access. The puncture site was infiltrated with
local anesthetic. The vessel was accessed using the modified Seldinger
technique, a wire was threaded into the vessel, and a sheath was advanced
over the wire into the vessel.
-- Lower Extremity Arteriogram..
HEMODYNAMIC TABLES
Outputs: Baseline
Outputs: -- CALCULATIONS: Age in years: 69.40
Outputs: -- CALCULATIONS: Height in cm: 185.00
Outputs: -- CALCULATIONS: Sex: Male