rconpatton
Contributor
procedures performed:
LHC
LV ANGIO
C. ANGIO
Selective bil renal angio
RT iliac angiography,
RT femoral angio with runoff
DISTAL Abdominal angio with runoff
Primary stenting of mid LC
Access site: Left femoral artery
After informed consent and sterile prep of both groins, the left femoral artery was cannulated with an initial stick and a 6 French sheath placed. Cardiac Cath was initially performed revealing high grade area of stenosis of the circumflex artery in its mid segment. The renal arteries were then selectively cannulated and showed no significant disease. The iliac bifurcation is very acute angle. A Glide wire Advantage wire was needed to cross into the right iliac system. Iliac angiography revealed a severe eccentric stenosis of the common femoral artery which is best seen in the LAO projection. Scattered areas of disease were noted in the SFA and a pressure gradient measurement revealed a pressure gradient is 20 mm across these lesions. Below-knee disease was as described above. The glide catheter was then exchanged for a 6 French pigtail catheter and the AI with runoff revealed high grade disease in the left SFA as above. It was decided to proceed with PCI of the circumflex artery and this was done using a 3.5 EBU guide and 0.14 Run through wire along with Integrity stent with good result. The patient will be referred to vascular surgery for femoral patch angioplasty as this would be his best treatment for the disease he has. Enrollment in a regular exercise program is planned. His left SFA disease is probably amenable PTA and this will be addressed at a later date. At the end of the procedure the left femoral sheath was sewn into place. No obvious complication occurred. The patient left the cardiac catheterization laboratory in stable condition.
Codes I came up with 93458-26, 36252-51, 92928-LC
Here is the confusion with the iliac system, that is not my strong area.
I get confused on cpt codes 36245,36246, and 36247
so after reading through my confusion I say 36247 75710-26
I thank you guys for helping me, I am the only one in my office, so I have no fellow co-workers to ask.
LHC
LV ANGIO
C. ANGIO
Selective bil renal angio
RT iliac angiography,
RT femoral angio with runoff
DISTAL Abdominal angio with runoff
Primary stenting of mid LC
Access site: Left femoral artery
After informed consent and sterile prep of both groins, the left femoral artery was cannulated with an initial stick and a 6 French sheath placed. Cardiac Cath was initially performed revealing high grade area of stenosis of the circumflex artery in its mid segment. The renal arteries were then selectively cannulated and showed no significant disease. The iliac bifurcation is very acute angle. A Glide wire Advantage wire was needed to cross into the right iliac system. Iliac angiography revealed a severe eccentric stenosis of the common femoral artery which is best seen in the LAO projection. Scattered areas of disease were noted in the SFA and a pressure gradient measurement revealed a pressure gradient is 20 mm across these lesions. Below-knee disease was as described above. The glide catheter was then exchanged for a 6 French pigtail catheter and the AI with runoff revealed high grade disease in the left SFA as above. It was decided to proceed with PCI of the circumflex artery and this was done using a 3.5 EBU guide and 0.14 Run through wire along with Integrity stent with good result. The patient will be referred to vascular surgery for femoral patch angioplasty as this would be his best treatment for the disease he has. Enrollment in a regular exercise program is planned. His left SFA disease is probably amenable PTA and this will be addressed at a later date. At the end of the procedure the left femoral sheath was sewn into place. No obvious complication occurred. The patient left the cardiac catheterization laboratory in stable condition.
Codes I came up with 93458-26, 36252-51, 92928-LC
Here is the confusion with the iliac system, that is not my strong area.
I get confused on cpt codes 36245,36246, and 36247
so after reading through my confusion I say 36247 75710-26
I thank you guys for helping me, I am the only one in my office, so I have no fellow co-workers to ask.
