endrest
Contributor
Can you bill for diagnostic arch angiogram and diagnostic angio of carotid during the same operative session upon placing a Carotid Stent (37215) what codes would you use?
Description of procedure is below.
THANK YOU!
NAME OF OPERATION/PROCEDURE:
1. Diagnostic arch angiogram.
2. Selective cannulation of the innominate artery and the right common
carotid artery.
3. Diagnostic angio of the carotid, as well as the cerebral right hemisphere.
4. Balloon angioplasty and stent of the right internal carotid artery using a
10 x 40-mm stent, there is pre dilatation with a 4 x 2 balloon followed by a
5 x 4 balloon post stent deployment angioplasty.
used an ultrasound for micropuncture
technique in the right groin. We then went up with a JB 2 catheter and
selective the innominate artery. Diagnostic angiograms were performed
showing the right common carotid artery with a severe stenosis of 85% distal
to the patch. We then placed a Magic Torque wire into the external carotid
artery. The patient was heparinized with 2000 units of heparin. A working
shuttle sheath was placed into the common carotid artery, this was then
followed by 4000 units of heparin. ACT was performed and found to be greater
than 250. At this time there was then use of a Cordis embolic protection
device which was able to cross the lesion. This was a 6-mm device and was
deployed without difficulty. Following this, based on the severity of the
stenosis, there was a preballoon dilatation with a 4 x 2 balloon. After
predilatation, there was then placement of the stent. The stent was a 10 x
10 in diameter x 40-mm stent. This was deployed and flared into the proximal
portion of the common carotid artery. Status post this there was then
balloon angioplasty with a 5 x 4 balloon. Status post balloon angioplasty
and stent, there was now minimal residual stenosis. Diagnostic cerebral
angiogram preprocedure and postprocedure showed no evidence of significant
malformation, no change preprocedure and postprocedure, as well as no
evidence of significant AV malformation.
Description of procedure is below.
THANK YOU!
NAME OF OPERATION/PROCEDURE:
1. Diagnostic arch angiogram.
2. Selective cannulation of the innominate artery and the right common
carotid artery.
3. Diagnostic angio of the carotid, as well as the cerebral right hemisphere.
4. Balloon angioplasty and stent of the right internal carotid artery using a
10 x 40-mm stent, there is pre dilatation with a 4 x 2 balloon followed by a
5 x 4 balloon post stent deployment angioplasty.
used an ultrasound for micropuncture
technique in the right groin. We then went up with a JB 2 catheter and
selective the innominate artery. Diagnostic angiograms were performed
showing the right common carotid artery with a severe stenosis of 85% distal
to the patch. We then placed a Magic Torque wire into the external carotid
artery. The patient was heparinized with 2000 units of heparin. A working
shuttle sheath was placed into the common carotid artery, this was then
followed by 4000 units of heparin. ACT was performed and found to be greater
than 250. At this time there was then use of a Cordis embolic protection
device which was able to cross the lesion. This was a 6-mm device and was
deployed without difficulty. Following this, based on the severity of the
stenosis, there was a preballoon dilatation with a 4 x 2 balloon. After
predilatation, there was then placement of the stent. The stent was a 10 x
10 in diameter x 40-mm stent. This was deployed and flared into the proximal
portion of the common carotid artery. Status post this there was then
balloon angioplasty with a 5 x 4 balloon. Status post balloon angioplasty
and stent, there was now minimal residual stenosis. Diagnostic cerebral
angiogram preprocedure and postprocedure showed no evidence of significant
malformation, no change preprocedure and postprocedure, as well as no
evidence of significant AV malformation.