bhargavi
Guru
Operation: Procedure(s):
Angiogram left axillary bypass
Specimens: *None
Indications and Findings: The patient is a 69 y.o. male who is status post left axillary to bilateral profundofemoral artery bypass performed last year. Patient was seen in office for routine observation and surveillance. Recent ultrasound suggested significant left axillary artery stenosis with elevated flow velocities. Patient denied significant claudication or rest pain but does have chronic mild claudication.
Procedure Details:
The patient was brought into the angiogram suite and placed on the table supine position both arms were kept at the patient's side. The left arm was adjusted slightly to provide access to the left axillary bypass. Chest wall was then prepped and draped in sterile fashion. A surgical timeout was performed according to hospital protocol. The skin subcutaneous tissue overlying the left axillary graft anesthetized with 1% lidocaine without epinephrine. The graft then accessed micropuncture needle set. Good return was noted. A microwire states this and directed superiorly. The needle was removed and a dilator sheath combination was advanced over the wire. The wire and dilator were removed leaving the sheath in place. An 035 Bentson wires were assistant directed superiorly. The dilator was removed and an 5 French sheath system was advanced over the wire. The dilator was removed and the sheath aspirated flushed with heparinized saline. A Kumpe catheter was advanced over the wire and placed into the proximal axillary artery beyond the anastomosis. This showed excellent filling of the proximal anastomosis. There was no evidence of significant stenosis. The catheter was then withdrawn into the proximal graft just past the anastomosis. Several retrograde injections were performed via different views. None of these showed any significant stenosis. It was decided at this point to take pictures of the left and right groins. The catheter was removed send hand-injection performed to the sheath performed. The left groin profundofemoral artery appeared widely patent. As was the right groin profundofemoral artery.
At this point the 5 French sheath was exchanged with a Perclose device and Perclose device used to close the puncture site. No significant bleeding was noted. The patient tolerated the procedure well.
should i just do 75710?
i am hospital coder
thanks in advance
Angiogram left axillary bypass
Specimens: *None
Indications and Findings: The patient is a 69 y.o. male who is status post left axillary to bilateral profundofemoral artery bypass performed last year. Patient was seen in office for routine observation and surveillance. Recent ultrasound suggested significant left axillary artery stenosis with elevated flow velocities. Patient denied significant claudication or rest pain but does have chronic mild claudication.
Procedure Details:
The patient was brought into the angiogram suite and placed on the table supine position both arms were kept at the patient's side. The left arm was adjusted slightly to provide access to the left axillary bypass. Chest wall was then prepped and draped in sterile fashion. A surgical timeout was performed according to hospital protocol. The skin subcutaneous tissue overlying the left axillary graft anesthetized with 1% lidocaine without epinephrine. The graft then accessed micropuncture needle set. Good return was noted. A microwire states this and directed superiorly. The needle was removed and a dilator sheath combination was advanced over the wire. The wire and dilator were removed leaving the sheath in place. An 035 Bentson wires were assistant directed superiorly. The dilator was removed and an 5 French sheath system was advanced over the wire. The dilator was removed and the sheath aspirated flushed with heparinized saline. A Kumpe catheter was advanced over the wire and placed into the proximal axillary artery beyond the anastomosis. This showed excellent filling of the proximal anastomosis. There was no evidence of significant stenosis. The catheter was then withdrawn into the proximal graft just past the anastomosis. Several retrograde injections were performed via different views. None of these showed any significant stenosis. It was decided at this point to take pictures of the left and right groins. The catheter was removed send hand-injection performed to the sheath performed. The left groin profundofemoral artery appeared widely patent. As was the right groin profundofemoral artery.
At this point the 5 French sheath was exchanged with a Perclose device and Perclose device used to close the puncture site. No significant bleeding was noted. The patient tolerated the procedure well.
should i just do 75710?
i am hospital coder
thanks in advance