aeberle2
Networker
Procedure performed:
1. Cannulation of the right common femoral artery.
2. Second order catheter placement in the left common femoral artery from the right side.
3. Attempt to cannulate an occluded left superficial femoral artery unsuccessfully.
Indications:
PVD, claudication. The pt was here last week. We attempted to cross the left SFA with traditional wires and catheters. However it was not successful. This time, we will bring him back to try a crosser device.
Description of Procedure:
After obtaining informed consent, the patient was brought into the cath lab. He was prepped and draped to obtain a sterile field. The right groin was anesthetized with 1% lidocaine. The right common femoral artery was cannulated using modified Seldinger technique with 5-French sheath. Them a RIM catheter was used to cannulate the left common iliac artery. At this point, a Terumo wire was placed distally in the left profunda femoris artery. The RIM catheter was advanced. The Terumo wire was removed. The Supracore wire was placed in the distal left profunda femoris. Then, the RIM catheter and the 5-French sheath were removed. At this point, a 7-French Raabe sheath was placed over the Supracore wire just above the level of the left common femoral artery. Then, the Supracore wire was removed. 5000 units of intravenous heparin were given. An attempt to cannulate the occluded left SFA using the crosser device failed after multiple trials. At this point, we decided to stop. The Raabe sheath was removed, exchanged into a short 7-French sheath, and an Angio-seal device was deployed. The patient tolerated well the procedure. There were no complications. He left the catheterization laboratory hemodynamically stable and neurologically intact.
Impression:
In conclusion, attempt to cannulate an occluded left SFA was unsuccessful. At this point, I would recommend medical therapy in terms of a walking program.
Can anyone tell me what, if anything, is billable for this unsuccessful procedure and how to code it? The only thing a can pick out is catheter placement into the left common femoral artery, but I am not sure if you can bill for catheter placement only. Thoughts?
1. Cannulation of the right common femoral artery.
2. Second order catheter placement in the left common femoral artery from the right side.
3. Attempt to cannulate an occluded left superficial femoral artery unsuccessfully.
Indications:
PVD, claudication. The pt was here last week. We attempted to cross the left SFA with traditional wires and catheters. However it was not successful. This time, we will bring him back to try a crosser device.
Description of Procedure:
After obtaining informed consent, the patient was brought into the cath lab. He was prepped and draped to obtain a sterile field. The right groin was anesthetized with 1% lidocaine. The right common femoral artery was cannulated using modified Seldinger technique with 5-French sheath. Them a RIM catheter was used to cannulate the left common iliac artery. At this point, a Terumo wire was placed distally in the left profunda femoris artery. The RIM catheter was advanced. The Terumo wire was removed. The Supracore wire was placed in the distal left profunda femoris. Then, the RIM catheter and the 5-French sheath were removed. At this point, a 7-French Raabe sheath was placed over the Supracore wire just above the level of the left common femoral artery. Then, the Supracore wire was removed. 5000 units of intravenous heparin were given. An attempt to cannulate the occluded left SFA using the crosser device failed after multiple trials. At this point, we decided to stop. The Raabe sheath was removed, exchanged into a short 7-French sheath, and an Angio-seal device was deployed. The patient tolerated well the procedure. There were no complications. He left the catheterization laboratory hemodynamically stable and neurologically intact.
Impression:
In conclusion, attempt to cannulate an occluded left SFA was unsuccessful. At this point, I would recommend medical therapy in terms of a walking program.
Can anyone tell me what, if anything, is billable for this unsuccessful procedure and how to code it? The only thing a can pick out is catheter placement into the left common femoral artery, but I am not sure if you can bill for catheter placement only. Thoughts?