Shirleybala
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Hello:
Can any one confirm my codes
Lumbar Arteries
36245
36245-59
75705
75705-59
Aortogram
75630
Internal iliacs
36247
75736
75774
36245-59
75736-59
embolization:
37204
75894
75898
Aortogram, pelvic arteriogram and embolization:
Clinical history: Trauma.
On an emergent basis, the patient was brought to the Interventional
Radiology Department. The patient's right groin was prepped and draped
in the usual sterile fashion. Several attempts at identifying the right
common femoral artery under ultrasound were unsuccessful. The patient's
left groin was, therefore, prepped and draped in the usual sterile
manner. The patient's left common femoral artery was punctured and a
vascular sheath was placed. Over a guide wire, a catheter was advanced
into the abdominal aorta and contrast injection was performed revealing
the abdominal aorta to be patent and normal in caliber. The left common
iliac, external iliac and internal iliac artery are visualized without
definite evidence of extravasation. Diminished flow within the right
common and external iliac artery was visualized.
Selective catheterization of several lumbar arteries was achieved.
Contrast injection was performed revealing no definite evidence of active
extravasation from any of the visualized right-sided lumbar arteries.
The catheter was exchanged and selective catheterization of the right
common iliac and subsequently internal iliac artery was achieved.
Contrast injection was performed revealing abrupt termination of the
anterior and posterior divisions of the internal iliac artery. Several
attempts at advancing a guide wire into the distal portions were
unsuccessful. Given the appearance on the patient's prior CT scan and
the abrupt termination of the vessels, avulsion of the vessels was
suspected and, therefore, a Gelfoam slurry embolization of the internal
iliac artery on the right was performed.
The catheter was withdrawn and contrast injection repeated revealing no
evidence of active extravasation. A branch vessel originating from the
internal iliac artery leading into the region of the right flank was
identified which also demonstrated abrupt termination but led to the site
of the patient's large right flank hematoma. Subselective
catheterization of this vessel with a microcatheter was achieved.
Contrast injection was performed revealing this to be the source of the
large flank hematoma. Coil embolization of this vessel with 2 and 3 mm
coils was achieved.The catheter was then repositioned into the right external iliac artery
and contrast injection was performed revealing abrupt termination of the
external iliac artery at the level of the femoral head. The common
femoral artery was not visualized.
The catheter was withdrawn and selective catheterization of the left
internal iliac artery was achieved. Contrast injection revealed no
evidence of extravasation from the left side.
The catheter was removed and the vascular sheath was left in place and
secured to the skin.
The patient tolerated the procedure without evidence of immediate
complication.
Can any one confirm my codes
Lumbar Arteries
36245
36245-59
75705
75705-59
Aortogram
75630
Internal iliacs
36247
75736
75774
36245-59
75736-59
embolization:
37204
75894
75898
Aortogram, pelvic arteriogram and embolization:
Clinical history: Trauma.
On an emergent basis, the patient was brought to the Interventional
Radiology Department. The patient's right groin was prepped and draped
in the usual sterile fashion. Several attempts at identifying the right
common femoral artery under ultrasound were unsuccessful. The patient's
left groin was, therefore, prepped and draped in the usual sterile
manner. The patient's left common femoral artery was punctured and a
vascular sheath was placed. Over a guide wire, a catheter was advanced
into the abdominal aorta and contrast injection was performed revealing
the abdominal aorta to be patent and normal in caliber. The left common
iliac, external iliac and internal iliac artery are visualized without
definite evidence of extravasation. Diminished flow within the right
common and external iliac artery was visualized.
Selective catheterization of several lumbar arteries was achieved.
Contrast injection was performed revealing no definite evidence of active
extravasation from any of the visualized right-sided lumbar arteries.
The catheter was exchanged and selective catheterization of the right
common iliac and subsequently internal iliac artery was achieved.
Contrast injection was performed revealing abrupt termination of the
anterior and posterior divisions of the internal iliac artery. Several
attempts at advancing a guide wire into the distal portions were
unsuccessful. Given the appearance on the patient's prior CT scan and
the abrupt termination of the vessels, avulsion of the vessels was
suspected and, therefore, a Gelfoam slurry embolization of the internal
iliac artery on the right was performed.
The catheter was withdrawn and contrast injection repeated revealing no
evidence of active extravasation. A branch vessel originating from the
internal iliac artery leading into the region of the right flank was
identified which also demonstrated abrupt termination but led to the site
of the patient's large right flank hematoma. Subselective
catheterization of this vessel with a microcatheter was achieved.
Contrast injection was performed revealing this to be the source of the
large flank hematoma. Coil embolization of this vessel with 2 and 3 mm
coils was achieved.The catheter was then repositioned into the right external iliac artery
and contrast injection was performed revealing abrupt termination of the
external iliac artery at the level of the femoral head. The common
femoral artery was not visualized.
The catheter was withdrawn and selective catheterization of the left
internal iliac artery was achieved. Contrast injection revealed no
evidence of extravasation from the left side.
The catheter was removed and the vascular sheath was left in place and
secured to the skin.
The patient tolerated the procedure without evidence of immediate
complication.