Wiki Embolization - Do we need to add any catheter

[prabha]

Can anyone help me out with this procedure.My codes are
37204
75894-26
75898-26
Do we need to add any catheter code.Pls confirm whether my codes are correct?
Procedure. Translumbar embolization of a type II leak.

Clinical information status post EVAR with type II leak. The
patient had previously had a translumbar embolization and arterial
embolization of the inferior mesenteric artery from the SMA.

Procedure.
Informed consent was obtained. The patient was prepped and draped
appropriately after being turned prone. After infiltration with
local anesthesia, an 18-gauge needle was advanced into the type II
leak using the previously placed coils as a marker.

Contrast injection demonstrates two contiguous sacs, the
lowermost of which filled the IMA passed the previously placed
coils. No other inflow or outflow was demonstrated.
An exchange was made for a 4-French Cobra catheter and attempts
made to catheterize the IMA without success. Accordingly the
lowermost sac was filled with 4 6 mm Nester coils and 2 4 mm
Nester coils to make a dense nest. A 10-mm coil was placed in the
uppermost sac. Contrast injection demonstrated no flow.

Impression. Translumbar embolization of a type II leak from the
IMA.

 

[heiditipherwell]

What I am getting from that dictation is that they could not place the catheter, therefore you cannot code it.

An exchange was made for a 4-French Cobra catheter and attempts
made to catheterize the IMA without success.
Hope that helps.
Heidi

 

[dpeoples]

Can anyone help me out with this procedure.My codes are
37204
75894-26
75898-26
Do we need to add any catheter code.Pls confirm whether my codes are correct?
Procedure. Translumbar embolization of a type II leak.

Clinical information status post EVAR with type II leak. The
patient had previously had a translumbar embolization and arterial
embolization of the inferior mesenteric artery from the SMA.

Procedure.
Informed consent was obtained. The patient was prepped and draped
appropriately after being turned prone. After infiltration with
local anesthesia, an 18-gauge needle was advanced into the type II
leak using the previously placed coils as a marker.

Contrast injection demonstrates two contiguous sacs, the
lowermost of which filled the IMA passed the previously placed
coils. No other inflow or outflow was demonstrated.
An exchange was made for a 4-French Cobra catheter and attempts
made to catheterize the IMA without success. Accordingly the
lowermost sac was filled with 4 6 mm Nester coils and 2 4 mm
Nester coils to make a dense nest. A 10-mm coil was placed in the
uppermost sac. Contrast injection demonstrated no flow.

Impression. Translumbar embolization of a type II leak from the
IMA.

My initial thought is, this is not a transcatheter embolization (37204) but I don't have enough information to give an alternative. What is an EVAR?

 

[ciphermed]

endovascular aneurysm repair

 

[dpeoples]

endovascular aneurysm repair

Thanks Anthony. I have coded hundreds of those and don't remember our surgeons using that acronym.

Based on that, I would code as such:
37204/75894.
36160
and 75898

HTH