Can someone help me with the codes for the below procedure?
Ultrasound guided access bilateral CFA
Bilateral lower extremity angiogram
Percutaneous closure of bilateral CFA
Aortogram with runoff
3rd order catheterization of lumbar artery
Embolization of lumbar artery
Repair of type II endoleak
Operative Indication: Patient presents with growing AAA aneurysm sac to 6.5 cm.
Operative Findings:
Type II endoleak from lumbar artery with successful glue embolization
Operative Description:
Patient was brought to the operating room and placed on the operating room table in supine position. After the induction of general anesthesia bilateral groins were prepped and draped in the usual sterile fashion. Under ultrasound guidance, bilateral common femoral arteries were accessed with a micropuncture needle and wire was advanced. Micropuncture sheath was placed and bilateral femoral angiograms were performed. Bentson wires were then placed in bilateral access sites were upsized to 6 French sheath. Perclose device was then partially deployed in both groins. 6 French sheath was then exchanged for 8 French sheaths and patient was given 8500 units of heparin intravenously to maintain ACT levels over 250 for the entirety of the case. Through the right sided access site a pigtail catheter was then advanced into the abdominal aorta within the stent graft and aortogram with runoff was obtained. Catheter was then withdrawn into the left sided limb and a persistent endoleak was noted. It appeared there was no extravasation of contrast through the graft intricacies. Type II endoleak was seen with retrograde flow from lumbar artery at the level of L5. Selective left iliac angiogram was then performed and decision was made to select for the lateral circumflex femoral artery as a branch off this appeared to be feeding the lumbar artery responsible for the endoleak. A Kumpe catheter was then advanced into the circumflex femoral artery and a 1 4 system and an 018 microcatheter was used to traverse the branch leading to the lumbar. Microcatheter was then positioned within the aneurysm sac and a lot of glue was used to embolize the sac and feeding corresponding lumbar artery. Follow-up angiogram revealed no further inflow into the aneurysm sac. Decision was made for no further aortograms given patient's stage III CKD. Wires catheters and sheaths were all removed Perclose devices were fully deployed in both groins successfully. Patient was given protamine for heparin reversal. Hemostasis was assured. Sterile dressings were applied and the patient was taken to the recovery room in stable condition.
Ultrasound guided access bilateral CFA
Bilateral lower extremity angiogram
Percutaneous closure of bilateral CFA
Aortogram with runoff
3rd order catheterization of lumbar artery
Embolization of lumbar artery
Repair of type II endoleak
Operative Indication: Patient presents with growing AAA aneurysm sac to 6.5 cm.
Operative Findings:
Type II endoleak from lumbar artery with successful glue embolization
Operative Description:
Patient was brought to the operating room and placed on the operating room table in supine position. After the induction of general anesthesia bilateral groins were prepped and draped in the usual sterile fashion. Under ultrasound guidance, bilateral common femoral arteries were accessed with a micropuncture needle and wire was advanced. Micropuncture sheath was placed and bilateral femoral angiograms were performed. Bentson wires were then placed in bilateral access sites were upsized to 6 French sheath. Perclose device was then partially deployed in both groins. 6 French sheath was then exchanged for 8 French sheaths and patient was given 8500 units of heparin intravenously to maintain ACT levels over 250 for the entirety of the case. Through the right sided access site a pigtail catheter was then advanced into the abdominal aorta within the stent graft and aortogram with runoff was obtained. Catheter was then withdrawn into the left sided limb and a persistent endoleak was noted. It appeared there was no extravasation of contrast through the graft intricacies. Type II endoleak was seen with retrograde flow from lumbar artery at the level of L5. Selective left iliac angiogram was then performed and decision was made to select for the lateral circumflex femoral artery as a branch off this appeared to be feeding the lumbar artery responsible for the endoleak. A Kumpe catheter was then advanced into the circumflex femoral artery and a 1 4 system and an 018 microcatheter was used to traverse the branch leading to the lumbar. Microcatheter was then positioned within the aneurysm sac and a lot of glue was used to embolize the sac and feeding corresponding lumbar artery. Follow-up angiogram revealed no further inflow into the aneurysm sac. Decision was made for no further aortograms given patient's stage III CKD. Wires catheters and sheaths were all removed Perclose devices were fully deployed in both groins successfully. Patient was given protamine for heparin reversal. Hemostasis was assured. Sterile dressings were applied and the patient was taken to the recovery room in stable condition.