amrcpc
Contributor
can 2 f/u angiograms be billed 
The right groin was prepped and draped in the usual sterile fashion. During the prior cerebral angiogram, the right common femoral artery was accessed with a micropuncture needle and a 5-French sheath was placed and connected to a saline flush. The
sheath was secured to the skin using a 2-0 silk suture and covered with a sterile Tegaderm and a sterile towel for later access during the surgery.
Findings:
Following placement of the initial aneurysm clip, we were called to the operating room to perform intraoperative cerebral angiogram. A 5-French Davis catheter and Glidewire were used to catheterize the left common carotid artery. Angiograms were
performed in multiple projections demonstratingsome residual aneurysm at the base along the anterior communicating artery. Approximately 80% of the aneurysm was occluded on the initial angiogram runs. The neurosurgeons decided to place another clip
while the catheter was being flushed. This run showed slightly less residual aneurysm at the base and no extravasation. The neurosurgeons in place a third clip, and a third follow-up angiogram demonstrated after clipping showed almost no residual
aneurysm at the base and no complication. Both anterior cerebral arteries distally filled normally.
The sheath was removed after surgery and pressure was held until hemostasis was achieved. There was no evidence of hematoma at time of hemostasis.
The total radiation dose was approximately:435 seconds
Images and report were permanently recorded.
The right groin was prepped and draped in the usual sterile fashion. During the prior cerebral angiogram, the right common femoral artery was accessed with a micropuncture needle and a 5-French sheath was placed and connected to a saline flush. The
sheath was secured to the skin using a 2-0 silk suture and covered with a sterile Tegaderm and a sterile towel for later access during the surgery.
Findings:
Following placement of the initial aneurysm clip, we were called to the operating room to perform intraoperative cerebral angiogram. A 5-French Davis catheter and Glidewire were used to catheterize the left common carotid artery. Angiograms were
performed in multiple projections demonstratingsome residual aneurysm at the base along the anterior communicating artery. Approximately 80% of the aneurysm was occluded on the initial angiogram runs. The neurosurgeons decided to place another clip
while the catheter was being flushed. This run showed slightly less residual aneurysm at the base and no extravasation. The neurosurgeons in place a third clip, and a third follow-up angiogram demonstrated after clipping showed almost no residual
aneurysm at the base and no complication. Both anterior cerebral arteries distally filled normally.
The sheath was removed after surgery and pressure was held until hemostasis was achieved. There was no evidence of hematoma at time of hemostasis.
The total radiation dose was approximately:435 seconds
Images and report were permanently recorded.