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maryir

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San Jose, CA
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The Dr is coding the service as a 93458. Is she correct?

o Indications For Cath:
 An indication for the procedure was chest pain.
 congestive heart failure

o Procedure Performed:
 Left heart catheterization and hemodynamics.
 Left-Heart Cath
 Coronary Angiography, selective
 Femoral Angiograhpy
 S-I,all other Injec Procs

Procedure Notes: The patient was given intravenous Versed and Fentanyl for sedation. Patient prepped and draped in the usual sterile fashion. Local infiltration anesthesia with 2% lidocaine was administered. The femoral artery was entered using a Seldinger technique. A 6F sheath was positioned in the artery and flushed with heparinized saline. A total of 77 Visipaque was used for contrast injections to minimize the risk of hemodynamic and renal complications.
• Catheters
o Diagnostic Catheters: 6F JL 4.0, JR 4.0,
• Post Procedure Events
o Sheath: After final injection, the catheter and sheath were removed, and hemostasis was achieved with the use of manual pressure.
Conclusions: 1) Co-dominant circulation.
2) No significant CAD (normal large caliber coronary arteries).
3) LVEDP: 4 mm Hg
4) Starclose RFA, right leg straight x 2 hrs.

The coronary anatomy shows mixed dominance.

Right Coronary Artery
This coronary vessel is normal.
Left Main Coronary Artery
This coronary vessel is normal.
Left Anterior Descending Coronary Artery
This coronary vessel is normal.
Circumflex Coronary Artery
This coronary vessel is normal.

Measurements Baseline
Gradients and Pressures
Name Value Units
LV SYSTOLIC 130 (mmHg)
LVEDIAS 4 (mmHg)
AORTIC SYSTOLIC 128 (mmHg)
AORTIC DIASTOLIC 71 (mmHg)
AORTIC MEAN 88 (mmHg)
 
maryir said:
The Dr is coding the service as a 93458. Is she correct?

o Indications For Cath:
 An indication for the procedure was chest pain.
 congestive heart failure

o Procedure Performed:
 Left heart catheterization and hemodynamics.
 Left-Heart Cath
 Coronary Angiography, selective
 Femoral Angiograhpy
 S-I,all other Injec Procs

Procedure Notes: The patient was given intravenous Versed and Fentanyl for sedation. Patient prepped and draped in the usual sterile fashion. Local infiltration anesthesia with 2% lidocaine was administered. The femoral artery was entered using a Seldinger technique. A 6F sheath was positioned in the artery and flushed with heparinized saline. A total of 77 Visipaque was used for contrast injections to minimize the risk of hemodynamic and renal complications.
• Catheters
o Diagnostic Catheters: 6F JL 4.0, JR 4.0,
• Post Procedure Events
o Sheath: After final injection, the catheter and sheath were removed, and hemostasis was achieved with the use of manual pressure.
Conclusions: 1) Co-dominant circulation.
2) No significant CAD (normal large caliber coronary arteries).
3) LVEDP: 4 mm Hg
4) Starclose RFA, right leg straight x 2 hrs.

The coronary anatomy shows mixed dominance.

Right Coronary Artery
This coronary vessel is normal.
Left Main Coronary Artery
This coronary vessel is normal.
Left Anterior Descending Coronary Artery
This coronary vessel is normal.
Circumflex Coronary Artery
This coronary vessel is normal.

Measurements Baseline
Gradients and Pressures
Name Value Units
LV SYSTOLIC 130 (mmHg)
LVEDIAS 4 (mmHg)
AORTIC SYSTOLIC 128 (mmHg)
AORTIC DIASTOLIC 71 (mmHg)
AORTIC MEAN 88 (mmHg)
Click to expand...

Looks right to me.

HTH :)
 
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