margaret fahy
Guru
01/15/16
Folks,
What codes would you use for this one?
PROCEDURE: The skin of the groin was prepped and draped in
sterile fashion and local anesthesia using 1 percent buffered
lidocaine was infused over the right common femoral artery.
Using Seldinger technique a 21g needle was inserted into the
right common femoral artery. Once arterial blood return was
obtained a .018" nitrix wire was placed in the artery. The
needle was removed and a 5F micropuncture sheath set was placed
over the wire into the artery and utilized to advance a .035"
glidewire. Over the wire a 4 French 45cm sheath was advanced
until the sheath was in the right internal carotid artery.
Biplane DSA was performed.
The 4 Fr sheath was placed at the right common carotid
bifurcation. An Ultraflow microcatheter with a Synchro-10
microwire was advanced through the right internal carotid artery
and selectively placed into the most proximal portion of the
ophthalmic artery. Contrast injection demonstrated good
opacification of the ophthalmic artery with prominent choroidal
blush. No reflux into the ICA was present.
Chemotherapeutic agent as ordered by the Oncology service per
protocol was injected into the right ophthalmic artery in a
pulsatile fashion at a rate of approximately 1 cc per min for a
total of 20 cc.
At the conclusion of the intra-arterial chemotherapy injection,
the catheter was flushed with saline to remove residual
chemotherapeutic agent. Contrast was injected as the
microcatheter was removed from the ophthalmic artery
demonstrating filling of the ophthalmic artery, choroidal blush
and with withdrawal, contrast within the internal carotid artery.
FINDINGS:
RICA: Biplane subtraction angiography revealed a patent opthalmic
artery and no arterial abnormality noted. The microcatheter was
positioned at the origin of the opthalmic artery for infusion of
chemotherapy.
IMPRESSION
Right ophthalmic artery intra-arterial chemotherapy as per
protocol.
Folks,
What codes would you use for this one?
PROCEDURE: The skin of the groin was prepped and draped in
sterile fashion and local anesthesia using 1 percent buffered
lidocaine was infused over the right common femoral artery.
Using Seldinger technique a 21g needle was inserted into the
right common femoral artery. Once arterial blood return was
obtained a .018" nitrix wire was placed in the artery. The
needle was removed and a 5F micropuncture sheath set was placed
over the wire into the artery and utilized to advance a .035"
glidewire. Over the wire a 4 French 45cm sheath was advanced
until the sheath was in the right internal carotid artery.
Biplane DSA was performed.
The 4 Fr sheath was placed at the right common carotid
bifurcation. An Ultraflow microcatheter with a Synchro-10
microwire was advanced through the right internal carotid artery
and selectively placed into the most proximal portion of the
ophthalmic artery. Contrast injection demonstrated good
opacification of the ophthalmic artery with prominent choroidal
blush. No reflux into the ICA was present.
Chemotherapeutic agent as ordered by the Oncology service per
protocol was injected into the right ophthalmic artery in a
pulsatile fashion at a rate of approximately 1 cc per min for a
total of 20 cc.
At the conclusion of the intra-arterial chemotherapy injection,
the catheter was flushed with saline to remove residual
chemotherapeutic agent. Contrast was injected as the
microcatheter was removed from the ophthalmic artery
demonstrating filling of the ophthalmic artery, choroidal blush
and with withdrawal, contrast within the internal carotid artery.
FINDINGS:
RICA: Biplane subtraction angiography revealed a patent opthalmic
artery and no arterial abnormality noted. The microcatheter was
positioned at the origin of the opthalmic artery for infusion of
chemotherapy.
IMPRESSION
Right ophthalmic artery intra-arterial chemotherapy as per
protocol.