JayRitten
Guest
I am new to this so any help would be greatly appreciated.
Repair of infrarenal AAA with modular bifurcated endoprosthesis
Main body Medtronic Endurant II
Left iliac extension limb
Right iliac extension limb
Abdominal aortogram
Right common femoral artery open exposure for placement of an endoprosthesis with primary closure.
Percutaneous left common femoral artery access for placement of an endoprosthesis.
Coding for Co-surgeons DR A and DR B
Procedure Description:
Transverse incision made on the right groin and common femoral artery, superficial femoral artery and profunda femorus artery all dissected free from surrounding tissues and controlled.
Left common femoral artery was accessed using modified Seldinger technique, 6 French sheath was positioned and 2 Perclose devices were successfully deployed and sutures were held out laterally and medially then at the end used for percutaneous closure.
On the right, 11 French sheath positioned in the common femoral artery. Wire advanced and KMP cath advanced to suprarenal level. Wire removed and Lunderquist wire advanced and positioned in the suprarenal aorta and the KMP cath was removed. On the left side, via the 6 French sheath, the shepherd's hook marker cath was advanced to the suprarenal level.
Main body device was advanced over the Lunderquist wire up the right common femoral artery side and advanced to the level of the lowest renal artery, which was the right side. Abdominal aortogram confirmed our position and then we were able to successfully deploy the stent with positioning of the graft just below the lowest renal, which was the right renal artery. Once this was completed, the graft was deployed until the contralateral limb was successfully deployed.
Using combination of Glidewire and the Sims 1 cath, the contralateral gate was accessed.
We were able to pass the cath within the lumen of the stent and rotated it, spun it around, so we could confirm that the cath was within the inside of the graft. Once this was completed, the Lunderquist wire was advanced into the suprarenal position, the Sims cath was removed, and the shepherd's hook marker cath was advanced. A left sided iliac arteriogram was then performed, so we could measure the length of the extension limb. The extension limb was then successfully advanced over the Lunderquist wire and successfully deployed all the way down to the level of the iliac artery bifurcation.
On the right side, an iliac extension was completely deployed and then I performed a right iliac arteriogram and then used an extension limb on the right side to bring the level of the endoprosthesis all the way down to the iliac bifurcation. Once this was completed, the device was removed leaving the wires in position.
We advance the Reliant balloon and performed angioplasty with the balloon at the proximal and distal landing zones and all junction zones to smooth out edges of the graft. Once this was completed, the shepherd's hook marker cath was reinserted into the suprarenal level, wire was removed and on the right side, a KMP cath was positioned in the graft to that the wire could be removed as well and then a completion aortogram was performed with an excellent technical result. On the left side, all wires and caths were removed and the 2 Perclose sutures were then cinched down with excellent hemostasis in the left groin, and then on the right side, all wires, caths, and devices were removed and the femoral artery was repaired with continuous sutures. Clamps released, procedure done.
This is what I have for cpt codes. And how does one split the S&I codes between the two doctors?
34812-62
36200-62
34802-62
34825-62
75952-26
75953-26
Repair of infrarenal AAA with modular bifurcated endoprosthesis
Main body Medtronic Endurant II
Left iliac extension limb
Right iliac extension limb
Abdominal aortogram
Right common femoral artery open exposure for placement of an endoprosthesis with primary closure.
Percutaneous left common femoral artery access for placement of an endoprosthesis.
Coding for Co-surgeons DR A and DR B
Procedure Description:
Transverse incision made on the right groin and common femoral artery, superficial femoral artery and profunda femorus artery all dissected free from surrounding tissues and controlled.
Left common femoral artery was accessed using modified Seldinger technique, 6 French sheath was positioned and 2 Perclose devices were successfully deployed and sutures were held out laterally and medially then at the end used for percutaneous closure.
On the right, 11 French sheath positioned in the common femoral artery. Wire advanced and KMP cath advanced to suprarenal level. Wire removed and Lunderquist wire advanced and positioned in the suprarenal aorta and the KMP cath was removed. On the left side, via the 6 French sheath, the shepherd's hook marker cath was advanced to the suprarenal level.
Main body device was advanced over the Lunderquist wire up the right common femoral artery side and advanced to the level of the lowest renal artery, which was the right side. Abdominal aortogram confirmed our position and then we were able to successfully deploy the stent with positioning of the graft just below the lowest renal, which was the right renal artery. Once this was completed, the graft was deployed until the contralateral limb was successfully deployed.
Using combination of Glidewire and the Sims 1 cath, the contralateral gate was accessed.
We were able to pass the cath within the lumen of the stent and rotated it, spun it around, so we could confirm that the cath was within the inside of the graft. Once this was completed, the Lunderquist wire was advanced into the suprarenal position, the Sims cath was removed, and the shepherd's hook marker cath was advanced. A left sided iliac arteriogram was then performed, so we could measure the length of the extension limb. The extension limb was then successfully advanced over the Lunderquist wire and successfully deployed all the way down to the level of the iliac artery bifurcation.
On the right side, an iliac extension was completely deployed and then I performed a right iliac arteriogram and then used an extension limb on the right side to bring the level of the endoprosthesis all the way down to the iliac bifurcation. Once this was completed, the device was removed leaving the wires in position.
We advance the Reliant balloon and performed angioplasty with the balloon at the proximal and distal landing zones and all junction zones to smooth out edges of the graft. Once this was completed, the shepherd's hook marker cath was reinserted into the suprarenal level, wire was removed and on the right side, a KMP cath was positioned in the graft to that the wire could be removed as well and then a completion aortogram was performed with an excellent technical result. On the left side, all wires and caths were removed and the 2 Perclose sutures were then cinched down with excellent hemostasis in the left groin, and then on the right side, all wires, caths, and devices were removed and the femoral artery was repaired with continuous sutures. Clamps released, procedure done.
This is what I have for cpt codes. And how does one split the S&I codes between the two doctors?
34812-62
36200-62
34802-62
34825-62
75952-26
75953-26