bevann0402@bellsouth.net
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I am thinking this should be CPT 93454. Could someone let me know if this is right/wrong...any help suggestions are greatly appreciated....I am trying (struggling) to learn this while also coding for a general surgeon, pulmonary specialist, plus an assortment of other physicians and np. I almost forgot, a rural health clinic...lol!!!!
Procedure performed:
6 French sheath placement in right common femoral artery
coronary angiography
right common femoral artery angiography
6 French angio-seal with good hemostasis, no hematoma to the right common femoral artery,
Indication
ventricular tachycardia, elevated cardiac enzymes, multiple risk factors for obstructive CAD, CHF
Procedure
The patient was transferred to coronary suite, prepped and draped in usual sterile fashion. Underwent 6-french sheath placement in the right common femoral vein without difficulty. coronary angiography was then performed. the left main is large and long without significant occlusions.
left circumflex is nondominant and large, showed 40% ostial disease, tapers to a small vessel. obtuse marginal #1 with 30% ostial disease. Obtuse marginal #2 is small and no significant occlusions.
the left anterior descending artery was large without significant occlusions. artery #1 large, no significant occlusions.
the RCA is large and dominant w/o significant occlusions. posterior descending artery medium-sized vessel dominant, no significant occlusions.
Please note that left ventriculogram was not performed. creatinine is elevated in this diabetic patient who was previously on metformin to 1.5 with a baseline of 1.0. we know by 2D echo that he had an LVEF greater than 55% so that conservation will be kept in place and ventriculogram not performed. NO significant valvular heart disease to the aortic or mitral valve was appreciated on echo.
at the close of the case, we underwent angiography of the right common femoral artery which was large and appropriate for Angio-seal. underwent 6-french angio-seal with good hemostasis. no hematoma. he underwent manual removal of the 6-french venous sheath with good hemostasis and no hematoma. patient left the lab in stable condition.
Thanks so much for reading and any help and suggestions!!
Beverly, CPC
Procedure performed:
6 French sheath placement in right common femoral artery
coronary angiography
right common femoral artery angiography
6 French angio-seal with good hemostasis, no hematoma to the right common femoral artery,
Indication
ventricular tachycardia, elevated cardiac enzymes, multiple risk factors for obstructive CAD, CHF
Procedure
The patient was transferred to coronary suite, prepped and draped in usual sterile fashion. Underwent 6-french sheath placement in the right common femoral vein without difficulty. coronary angiography was then performed. the left main is large and long without significant occlusions.
left circumflex is nondominant and large, showed 40% ostial disease, tapers to a small vessel. obtuse marginal #1 with 30% ostial disease. Obtuse marginal #2 is small and no significant occlusions.
the left anterior descending artery was large without significant occlusions. artery #1 large, no significant occlusions.
the RCA is large and dominant w/o significant occlusions. posterior descending artery medium-sized vessel dominant, no significant occlusions.
Please note that left ventriculogram was not performed. creatinine is elevated in this diabetic patient who was previously on metformin to 1.5 with a baseline of 1.0. we know by 2D echo that he had an LVEF greater than 55% so that conservation will be kept in place and ventriculogram not performed. NO significant valvular heart disease to the aortic or mitral valve was appreciated on echo.
at the close of the case, we underwent angiography of the right common femoral artery which was large and appropriate for Angio-seal. underwent 6-french angio-seal with good hemostasis. no hematoma. he underwent manual removal of the 6-french venous sheath with good hemostasis and no hematoma. patient left the lab in stable condition.
Thanks so much for reading and any help and suggestions!!
Beverly, CPC