Wiki Carotid Arteriogram

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amym

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Still trying to learn to code endovascular procedures and am not exposed to it that much. Seeing a report such as this almost had me running for the hills. I am going to take a wild guess and go with 36222 but please help with coding. CT Angio performed within a 30 day time frame.:eek:

PROCEDURES PERFORMED:

-- Right Carotid Arteriogram.
-- Left Carotid Arteriogram.
-- Aortagram run off.

ARCH VESSELS: Proximal left common carotid: Normal. Mid left common
carotid: Normal. Distal left common carotid: Normal. Proximal right common
carotid: Normal. Mid right common carotid: Normal. Distal right common
carotid: Normal. Proximal left internal carotid: Normal. Mid left internal
carotid: Normal. Distal left internal carotid: Normal. Proximal right
internal carotid: Normal. Mid right internal carotid: Normal. Distal right
internal carotid: Normal. Proximal left external carotid: Normal. Mid left
external carotid: Normal. Distal left external carotid: Normal. Right
external carotid: Normal. Proximal right external carotid: Normal. Mid
right external carotid: Normal. Distal right external carotid: Normal.
Innominate: Normal. Proximal right subclavian: Normal. Mid right
subclavian: Normal.

LEFT LOWER EXTREMITY VESSELS: Proximal left common iliac: Normal. Mid left
common iliac: Normal. Distal left common iliac: Normal. Proximal left
internal iliac: Normal. Mid left internal iliac: Normal. Distal left
internal iliac: Normal. Proximal left external iliac: Normal. Angiography
showed minor luminal irregularities. Mid left external iliac: Normal.
Angiography showed minor luminal irregularities. Distal left external
iliac: Normal. Angiography showed minor luminal irregularities. Proximal
left common femoral: Normal. Angiography showed minor luminal
irregularities. Mid left common femoral: Normal. Distal left common
femoral: Normal. Angiography showed minor luminal irregularities. Ostial
left superficial femoral: Angiography showed minor luminal irregularities.
Proximal left superficial femoral: Angiography showed minor luminal
irregularities. Mid left superficial femoral: Angiography showed minor
luminal irregularities. Distal left superficial femoral: Angiography
showed minor luminal irregularities. Ostial left deep femoral: Angiography
showed minor luminal irregularities. Proximal left deep femoral:
Angiography showed minor luminal irregularities. Mid left deep femoral:
Angiography showed minor luminal irregularities. Distal left deep femoral:
Angiography showed minor luminal irregularities. Proximal left popliteal:
Angiography showed minor luminal irregularities. Mid left popliteal:
Angiography showed minor luminal irregularities. Distal left popliteal:
Angiography showed minor luminal irregularities. Ostial left anterior
tibial: Angiography showed minor luminal irregularities. Proximal left
anterior tibial: Angiography showed minor luminal irregularities. Mid left
anterior tibial: Angiography showed minor luminal irregularities. Distal
left anterior tibial: Angiography showed minor luminal irregularities.
Left tibio-peroneal: Angiography showed minor luminal irregularities.
Ostial left tibio-peroneal: Angiography showed minor luminal
irregularities. Ostial left posterior tibial: There was a 100 % stenosis.
Proximal left posterior tibial: There was a 100 % stenosis. Mid left
posterior tibial: There was a 100 % stenosis. Distal left posterior
tibial: There was a 100 % stenosis. Proximal left peroneal: Angiography
showed minor luminal irregularities. Distal left peroneal: Angiography
showed minor luminal irregularities.

RIGHT LOWER EXTREMITY VESSELS: Ostial right common iliac: Normal. Proximal
right common iliac: Normal. Mid right common iliac: Normal. Distal right
common iliac: Normal. Proximal right internal iliac: Normal. Mid right
internal iliac: Normal. Distal right internal iliac: Normal. Proximal
right external iliac: Normal. Mid right external iliac: Normal. Distal
right external iliac: Normal. Proximal right common femoral: Normal. Mid
right common femoral: Normal. Distal right common femoral: Normal. Ostial
right superficial femoral: Normal. Proximal right superficial femoral:
Normal. There was a diffuse 75 % stenosis. Distal right superficial
femoral: There was a diffuse 75 % stenosis. Ostial right deep femoral:
Angiography showed minor luminal irregularities. Proximal right deep
femoral: Angiography showed minor luminal irregularities. Mid right deep
femoral: Angiography showed minor luminal irregularities. Distal right
deep femoral: Angiography showed minor luminal irregularities. Proximal
right popliteal: Angiography showed minor luminal irregularities. There
was a diffuse 75 % stenosis. Mid right popliteal: Angiography showed minor
luminal irregularities. There was a diffuse 75 % stenosis. Distal right
popliteal: The vessel was patent. Proximal right anterior tibial: The
vessel was patent. Mid right anterior tibial: Normal. Distal right
anterior tibial: Normal. Right tibio-peroneal: The vessel was patent.
Ostial right posterior tibial: There was a 100 % stenosis. Proximal right
posterior tibial: There was a 100 % stenosis. Ostial right peroneal: The
vessel was patent. Proximal right peroneal: Angiography showed minor
luminal irregularities. Mid right peroneal: Angiography showed minor
luminal irregularities.

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.

-- Right Carotid Arteriogram..

-- Left Carotid Arteriogram..

-- Aortagram run off..
 
amym said:
Still trying to learn to code endovascular procedures and am not exposed to it that much. Seeing a report such as this almost had me running for the hills. I am going to take a wild guess and go with 36222 but please help with coding. CT Angio performed within a 30 day time frame.:eek:

PROCEDURES PERFORMED:

-- Right Carotid Arteriogram.
-- Left Carotid Arteriogram.
-- Aortagram run off.

ARCH VESSELS: Proximal left common carotid: Normal. Mid left common
carotid: Normal. Distal left common carotid: Normal. Proximal right common
carotid: Normal. Mid right common carotid: Normal. Distal right common
carotid: Normal. Proximal left internal carotid: Normal. Mid left internal
carotid: Normal. Distal left internal carotid: Normal. Proximal right
internal carotid: Normal. Mid right internal carotid: Normal. Distal right
internal carotid: Normal. Proximal left external carotid: Normal. Mid left
external carotid: Normal. Distal left external carotid: Normal. Right
external carotid: Normal. Proximal right external carotid: Normal. Mid
right external carotid: Normal. Distal right external carotid: Normal.
Innominate: Normal. Proximal right subclavian: Normal. Mid right
subclavian: Normal.

LEFT LOWER EXTREMITY VESSELS: Proximal left common iliac: Normal. Mid left
common iliac: Normal. Distal left common iliac: Normal. Proximal left
internal iliac: Normal. Mid left internal iliac: Normal. Distal left
internal iliac: Normal. Proximal left external iliac: Normal. Angiography
showed minor luminal irregularities. Mid left external iliac: Normal.
Angiography showed minor luminal irregularities. Distal left external
iliac: Normal. Angiography showed minor luminal irregularities. Proximal
left common femoral: Normal. Angiography showed minor luminal
irregularities. Mid left common femoral: Normal. Distal left common
femoral: Normal. Angiography showed minor luminal irregularities. Ostial
left superficial femoral: Angiography showed minor luminal irregularities.
Proximal left superficial femoral: Angiography showed minor luminal
irregularities. Mid left superficial femoral: Angiography showed minor
luminal irregularities. Distal left superficial femoral: Angiography
showed minor luminal irregularities. Ostial left deep femoral: Angiography
showed minor luminal irregularities. Proximal left deep femoral:
Angiography showed minor luminal irregularities. Mid left deep femoral:
Angiography showed minor luminal irregularities. Distal left deep femoral:
Angiography showed minor luminal irregularities. Proximal left popliteal:
Angiography showed minor luminal irregularities. Mid left popliteal:
Angiography showed minor luminal irregularities. Distal left popliteal:
Angiography showed minor luminal irregularities. Ostial left anterior
tibial: Angiography showed minor luminal irregularities. Proximal left
anterior tibial: Angiography showed minor luminal irregularities. Mid left
anterior tibial: Angiography showed minor luminal irregularities. Distal
left anterior tibial: Angiography showed minor luminal irregularities.
Left tibio-peroneal: Angiography showed minor luminal irregularities.
Ostial left tibio-peroneal: Angiography showed minor luminal
irregularities. Ostial left posterior tibial: There was a 100 % stenosis.
Proximal left posterior tibial: There was a 100 % stenosis. Mid left
posterior tibial: There was a 100 % stenosis. Distal left posterior
tibial: There was a 100 % stenosis. Proximal left peroneal: Angiography
showed minor luminal irregularities. Distal left peroneal: Angiography
showed minor luminal irregularities.

RIGHT LOWER EXTREMITY VESSELS: Ostial right common iliac: Normal. Proximal
right common iliac: Normal. Mid right common iliac: Normal. Distal right
common iliac: Normal. Proximal right internal iliac: Normal. Mid right
internal iliac: Normal. Distal right internal iliac: Normal. Proximal
right external iliac: Normal. Mid right external iliac: Normal. Distal
right external iliac: Normal. Proximal right common femoral: Normal. Mid
right common femoral: Normal. Distal right common femoral: Normal. Ostial
right superficial femoral: Normal. Proximal right superficial femoral:
Normal. There was a diffuse 75 % stenosis. Distal right superficial
femoral: There was a diffuse 75 % stenosis. Ostial right deep femoral:
Angiography showed minor luminal irregularities. Proximal right deep
femoral: Angiography showed minor luminal irregularities. Mid right deep
femoral: Angiography showed minor luminal irregularities. Distal right
deep femoral: Angiography showed minor luminal irregularities. Proximal
right popliteal: Angiography showed minor luminal irregularities. There
was a diffuse 75 % stenosis. Mid right popliteal: Angiography showed minor
luminal irregularities. There was a diffuse 75 % stenosis. Distal right
popliteal: The vessel was patent. Proximal right anterior tibial: The
vessel was patent. Mid right anterior tibial: Normal. Distal right
anterior tibial: Normal. Right tibio-peroneal: The vessel was patent.
Ostial right posterior tibial: There was a 100 % stenosis. Proximal right
posterior tibial: There was a 100 % stenosis. Ostial right peroneal: The
vessel was patent. Proximal right peroneal: Angiography showed minor
luminal irregularities. Mid right peroneal: Angiography showed minor
luminal irregularities.

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.

-- Right Carotid Arteriogram..

-- Left Carotid Arteriogram..

-- Aortagram run off..
Click to expand...

Hi Amy,
I hate to diss Drs. dictations, but if this is what you got.....
I would bill 36221 or maybe 36222-50, 75630. There is no description of where the catheter was placed, what was imaged from where. The carotids could have been imaged from the arch. Sorry!
HTH,
Jim Pawloski, CIRCC
 
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