Shirleybala
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Hello:
In this AV FISTULOGRAM should we need to code for
1.Brachial artery angiogram.
2.Brachial artery angioplasty.
3.What will be the cath code.
Ultrasound examination of the arteriovenous anastomosis was
performed. After administering local anesthesia, a 7 French
vascular sheaths were placed into the outflow vein aiming
caudally. Contrast injection with digital imaging of the venous
outflow to the level of the superior vena cava was performed
demonstrating wide patency of the cephalic and central outflow
veins. A four French Berenstein catheter and-a guide wire were
advanced through the upper sheath and guided to the arteriovenous
anastomosis. Multiple attempts to cross the arteriovenous
anastomosis were unsuccessful.
The inflow brachial artery was accessed in the midportion of the
upper arm in antegrade fashion using the micropuncture system.
The 3-French inner dilator from the micropuncture kit was advanced
into the artery. Brachial artery angiography in the frontal
projection was performed. A 0 .018 inch gold tip Glidewire was
advanced through the catheter, guided beyond the arteriovenous
anastomosis and further advanced into the venous sheath. The
sheath was removed and the wire withdrawn out of the skin.
Through-and-through access was then obtained and the sheath
readvanced over the wire. A 4 -French Berenstein catheter was
advanced over the wire and into the inflow brachial artery. After
exchanging for a stiff hydrophilic wire, the arteriovenous
anastomotic stenosis was sequentially dilated using 6 and 7 mm x 4
cm Cordis Extreme angioplasty balloons. Severe spasm was noted
within the inflow brachial artery. The entire length of the
brachial artery extending for approximately 10 cm from the
arteriovenous anastomosis was dilated using a 5 mm x 4 cm
angioplasty balloon. A final angiogram was performed
demonstrating wide patency with minimal recoiling at the
angioplasty sites. An improved thrill was palpated within the
fistula at termination of the procedure. The sheaths were removed
and hemostasis was obtained with manual compression
In this AV FISTULOGRAM should we need to code for
1.Brachial artery angiogram.
2.Brachial artery angioplasty.
3.What will be the cath code.
Ultrasound examination of the arteriovenous anastomosis was
performed. After administering local anesthesia, a 7 French
vascular sheaths were placed into the outflow vein aiming
caudally. Contrast injection with digital imaging of the venous
outflow to the level of the superior vena cava was performed
demonstrating wide patency of the cephalic and central outflow
veins. A four French Berenstein catheter and-a guide wire were
advanced through the upper sheath and guided to the arteriovenous
anastomosis. Multiple attempts to cross the arteriovenous
anastomosis were unsuccessful.
The inflow brachial artery was accessed in the midportion of the
upper arm in antegrade fashion using the micropuncture system.
The 3-French inner dilator from the micropuncture kit was advanced
into the artery. Brachial artery angiography in the frontal
projection was performed. A 0 .018 inch gold tip Glidewire was
advanced through the catheter, guided beyond the arteriovenous
anastomosis and further advanced into the venous sheath. The
sheath was removed and the wire withdrawn out of the skin.
Through-and-through access was then obtained and the sheath
readvanced over the wire. A 4 -French Berenstein catheter was
advanced over the wire and into the inflow brachial artery. After
exchanging for a stiff hydrophilic wire, the arteriovenous
anastomotic stenosis was sequentially dilated using 6 and 7 mm x 4
cm Cordis Extreme angioplasty balloons. Severe spasm was noted
within the inflow brachial artery. The entire length of the
brachial artery extending for approximately 10 cm from the
arteriovenous anastomosis was dilated using a 5 mm x 4 cm
angioplasty balloon. A final angiogram was performed
demonstrating wide patency with minimal recoiling at the
angioplasty sites. An improved thrill was palpated within the
fistula at termination of the procedure. The sheaths were removed
and hemostasis was obtained with manual compression