karbaker
Guest
abdominal aortogram
bilateral peripheral angio and runoffs
we coded
36200, 75716-26, 75625-26 report attached
ABDOMINAL AORTOGRAM AND RUNOFF STUDY.
DATE OF SERVICE: 12/11/2012
REFERRING PHYSICIAN:
PROCEDURES PERFORMED:
1.
Abdominal aortogram.
2.
Bilateral peripheral runoffs.
INDICATION: has peripheral vascular disease and has a nonhealing ulcer on the left leg.
PROCEDURE: Informed consent was obtained from the patient. The patient was brought to the cardiac catheterization laboratory in a fasting state. A 5-French sheath is placed into the right femoral artery. A pigtail is then advanced through the sheath above the origin of the renal arteries and an abdominal aortogram was first performed. After this the pigtail was pulled down at the level of bifurcation of the aorta and a runoff study was done for both legs. After this all the catheters, wires, and tubes were withdrawn. Manual pressure is held. The patient is transferred back to his room in a stable condition. The patient tolerated the procedure well.
FINDINGS:
1.
Normal abdominal aorta.
2.
Normal bilateral renal arteries.
3.
Normal superior and inferior mesenteric arteries.
4.
Normal bifurcation of the aorta into the right and left common iliac arteries.
5.
Normal right and left external and internal iliac arteries.
6.
Normal right and left femoral arteries.
7.
Normal right and left superficial femoral and deep femoral arteries.
8.
The left popliteal artery is normal.
9.
The left posterior tibial artery is completely occluded.
10.The left anterior tibial artery has an ostial 90% stenosis, following which there is slow flow in the anterior tibial artery and then it also becomes completely occluded in the mid segment.
11.The only patent vessel below the knee is the left peroneal artery which has at least in 2 places focal lesions of 90% stenosis with 1vessel runoff to the left foot.
CONCLUSIONS: Severe below-the-knee peripheral vascular disease in the left leg with 1-vessel runoff to the left foot as described above.
RECOMMENDATIONS: The patient will be seen by Dr. his vascular surgeon, and further recommendations will be made.
bilateral peripheral angio and runoffs
we coded
36200, 75716-26, 75625-26 report attached
ABDOMINAL AORTOGRAM AND RUNOFF STUDY.
DATE OF SERVICE: 12/11/2012
REFERRING PHYSICIAN:
PROCEDURES PERFORMED:
1.
Abdominal aortogram.
2.
Bilateral peripheral runoffs.
INDICATION: has peripheral vascular disease and has a nonhealing ulcer on the left leg.
PROCEDURE: Informed consent was obtained from the patient. The patient was brought to the cardiac catheterization laboratory in a fasting state. A 5-French sheath is placed into the right femoral artery. A pigtail is then advanced through the sheath above the origin of the renal arteries and an abdominal aortogram was first performed. After this the pigtail was pulled down at the level of bifurcation of the aorta and a runoff study was done for both legs. After this all the catheters, wires, and tubes were withdrawn. Manual pressure is held. The patient is transferred back to his room in a stable condition. The patient tolerated the procedure well.
FINDINGS:
1.
Normal abdominal aorta.
2.
Normal bilateral renal arteries.
3.
Normal superior and inferior mesenteric arteries.
4.
Normal bifurcation of the aorta into the right and left common iliac arteries.
5.
Normal right and left external and internal iliac arteries.
6.
Normal right and left femoral arteries.
7.
Normal right and left superficial femoral and deep femoral arteries.
8.
The left popliteal artery is normal.
9.
The left posterior tibial artery is completely occluded.
10.The left anterior tibial artery has an ostial 90% stenosis, following which there is slow flow in the anterior tibial artery and then it also becomes completely occluded in the mid segment.
11.The only patent vessel below the knee is the left peroneal artery which has at least in 2 places focal lesions of 90% stenosis with 1vessel runoff to the left foot.
CONCLUSIONS: Severe below-the-knee peripheral vascular disease in the left leg with 1-vessel runoff to the left foot as described above.
RECOMMENDATIONS: The patient will be seen by Dr. his vascular surgeon, and further recommendations will be made.