Wiki Angiogram coding

[todd5400]

I would appreciate some help with this one. I have not coded one of these!

1. Right transthermal cerebral angiogram, supra-selective catheterization multiple thoracic spinal levels. Conscious sedation for 47 minutes
2. Catherization of the right and left T7, T8, T9, T10 and T11 levels.

Procedure: With intravenous combination of Versed and Fentanyl using micropuncture technique, the right common femoral artery was accessed, dilated to a 5 french sheath which was connected to a continuous Heparinized flush system. A 5 french Michel-Stein catheter was used. The thoracic and abdominal aortas were extremely atherosclerotic making it difficult to selective catheterize the segmental vessels. During segmental catheterization of the left T10 vessel this was demonstrated to be the artery of adenkavich. Supraselective catheterization of the right T7 segmental vessel revealed a dural AV fistula with the fistula occurring at the level of the pedicle of T7. Runs down at other levels demonstrate atherosclerotic changes in segmental vessels without evidence of dural fistulas.
Once accomplished all catheters and wires removed.
Impression: Right T7 segmental vessel leading to dural AV fistula at the right T7 pedicle. The artery of adenkavich arises from the left T10 segmental vessel.

Thanks in advance
Mary,CPC

 

[mikereyland]

From what I remember 36215 x10 (you may run into a units issue so you may have to spread them out) 75705 x10 (again you might have to spread these out).

 

[Jim Pawloski]

I would appreciate some help with this one. I have not coded one of these!

1. Right transthermal cerebral angiogram, supra-selective catheterization multiple thoracic spinal levels. Conscious sedation for 47 minutes
2. Catherization of the right and left T7, T8, T9, T10 and T11 levels.

Procedure: With intravenous combination of Versed and Fentanyl using micropuncture technique, the right common femoral artery was accessed, dilated to a 5 french sheath which was connected to a continuous Heparinized flush system. A 5 french Michel-Stein catheter was used. The thoracic and abdominal aortas were extremely atherosclerotic making it difficult to selective catheterize the segmental vessels. During segmental catheterization of the left T10 vessel this was demonstrated to be the artery of adenkavich. Supraselective catheterization of the right T7 segmental vessel revealed a dural AV fistula with the fistula occurring at the level of the pedicle of T7. Runs down at other levels demonstrate atherosclerotic changes in segmental vessels without evidence of dural fistulas.
Once accomplished all catheters and wires removed.
Impression: Right T7 segmental vessel leading to dural AV fistula at the right T7 pedicle. The artery of adenkavich arises from the left T10 segmental vessel.

Thanks in advance
Mary,CPC

This one was fun reading. I would bill this as:
36216 for the supraselective cath of t-7
36215 - 59 x 9 for selective spinal artery
75705 x 10 for S&I of spinal arteries.

I hope this helps,
Jim Pawloski RT (CV) CIRCC