Can anyone confirm me the codes for the below procedure.......
37201
75896-26
75898-26
The patient's right groin, existing sheath and catheter were
double prepped and draped in the usual sterile manner and locally
anesthetized with 1% lidocaine. The existing multi-sidehole
infusion catheter(placed overnight) was exchanged out over an exchange length wire.
Contrast was injected over the up and over vascular sheath and
digital subtraction angiography was performed of the left lower
extremity in multiple stations. A total of 35 cc of Visipaque 270
used as intravascular contrast. 3.3 minutes fluoroscopy time.
Findings:
The distal superficial femoral artery is now patent, status post
overnight thrombolytic infusion. The popliteal artery, however is
occluded. There is reconstitution of all 3 tibial arteries at
their origin, with visualization of the anterior tibial,
tibioperoneal trunk, peroneal and posterior tibial arteries.
After restoration of patency to the SFA, now the proximal hood of
the bypass graft is identifiable.
Intervention:
A decision was made to catheterize the bypass graft now that its
location is identifiable, and position a multi-sidehole infusion
catheter in the bypass graft to allow for infusion directly into
the bypass graft throughout the day. Later in the afternoon the
patient will be brought brought back down for followup imaging.
A Berenstein catheter and Bentson wire were used to easily
selectively catheterize the bypass graft. The Bentson wire did
advance into the bypass graft. The distal anastomosis, however
could not be negotiated and the catheter kept entering what
appeared to be a collateral vessel.
A 10 cm multi-sidehole infusion infusion catheter was then placed
with the sideholes across the occluded bypass graft. Plan to
infuse 0.75 mg TPA per hour for the next 5 hours or so, at which
time he will come back for followup imaging. Also plan to continue
low dose heparin infusion via the up and over vascular sheath to
prevent pericatheter thrombosis.
Impression:
The distal SFA is now patent status post overnight thrombolytic
infusion. Also, the hood of the distal bypass graft which arises
from the distal SFA is now identifiable. There is reconstitution
at the tibial trifurcation, with runoff via all 3 tibial vessels.
Now that the bypass graft is identifiable, it was easily
selectively catheterized and a 10 cm multi-sidehole infusion
catheter placed across the occluded bypass graft.
37201
75896-26
75898-26
The patient's right groin, existing sheath and catheter were
double prepped and draped in the usual sterile manner and locally
anesthetized with 1% lidocaine. The existing multi-sidehole
infusion catheter(placed overnight) was exchanged out over an exchange length wire.
Contrast was injected over the up and over vascular sheath and
digital subtraction angiography was performed of the left lower
extremity in multiple stations. A total of 35 cc of Visipaque 270
used as intravascular contrast. 3.3 minutes fluoroscopy time.
Findings:
The distal superficial femoral artery is now patent, status post
overnight thrombolytic infusion. The popliteal artery, however is
occluded. There is reconstitution of all 3 tibial arteries at
their origin, with visualization of the anterior tibial,
tibioperoneal trunk, peroneal and posterior tibial arteries.
After restoration of patency to the SFA, now the proximal hood of
the bypass graft is identifiable.
Intervention:
A decision was made to catheterize the bypass graft now that its
location is identifiable, and position a multi-sidehole infusion
catheter in the bypass graft to allow for infusion directly into
the bypass graft throughout the day. Later in the afternoon the
patient will be brought brought back down for followup imaging.
A Berenstein catheter and Bentson wire were used to easily
selectively catheterize the bypass graft. The Bentson wire did
advance into the bypass graft. The distal anastomosis, however
could not be negotiated and the catheter kept entering what
appeared to be a collateral vessel.
A 10 cm multi-sidehole infusion infusion catheter was then placed
with the sideholes across the occluded bypass graft. Plan to
infuse 0.75 mg TPA per hour for the next 5 hours or so, at which
time he will come back for followup imaging. Also plan to continue
low dose heparin infusion via the up and over vascular sheath to
prevent pericatheter thrombosis.
Impression:
The distal SFA is now patent status post overnight thrombolytic
infusion. Also, the hood of the distal bypass graft which arises
from the distal SFA is now identifiable. There is reconstitution
at the tibial trifurcation, with runoff via all 3 tibial vessels.
Now that the bypass graft is identifiable, it was easily
selectively catheterized and a 10 cm multi-sidehole infusion
catheter placed across the occluded bypass graft.
