Rita Bartholomew
Guru
I'm stuck on this one. I've got 37204/75894 for the embolization and 77012 for the CT guidance, but what code would be used for the needle placement into the aortic aneursym sac?
INDICATION: AAA ENDOLEAK
ANGIOGRAM OF THE AORTA AND SAC EMBOLIZATION: The risks were explained and informed consent was obtained. Monitored conscious sedation was used for approximately 45 minutes. A needle and guidewire were placed with CT guidance into the aortic sac using a posterior right-sided approach. The patient was then transferred to the Angio Suite. A catheter was placed over the 0.018 wire, and a 5 French catheter was placed into the sac and angiogram was performed. It showed filling of the upper sac. It showed the sac to be patent in the upper area. A vessel was noted exiting from the sac on the right side extending down to the pelvis which I suspect is a colonic branch filling retrograde via retroperitoneal artery. The sac was embolized with a combination of 6 millimeter diameter to 14 millimeter diameter Boston Scientific coils. Stasis was achieved. Follow-up angiogram showed no residual filling of the sac or egressing vessels. The needle was removed. The patient was recovered. He felt fine at four hours and he was discharged uneventfully.
Follow-up CT scan is scheduled for one week with re-evaluation of the aneurysm sac.
IMPRESSION: Successful embolization was performed of the upper sac with a good angiographic result. CT is pending.
INDICATION: AAA ENDOLEAK
ANGIOGRAM OF THE AORTA AND SAC EMBOLIZATION: The risks were explained and informed consent was obtained. Monitored conscious sedation was used for approximately 45 minutes. A needle and guidewire were placed with CT guidance into the aortic sac using a posterior right-sided approach. The patient was then transferred to the Angio Suite. A catheter was placed over the 0.018 wire, and a 5 French catheter was placed into the sac and angiogram was performed. It showed filling of the upper sac. It showed the sac to be patent in the upper area. A vessel was noted exiting from the sac on the right side extending down to the pelvis which I suspect is a colonic branch filling retrograde via retroperitoneal artery. The sac was embolized with a combination of 6 millimeter diameter to 14 millimeter diameter Boston Scientific coils. Stasis was achieved. Follow-up angiogram showed no residual filling of the sac or egressing vessels. The needle was removed. The patient was recovered. He felt fine at four hours and he was discharged uneventfully.
Follow-up CT scan is scheduled for one week with re-evaluation of the aneurysm sac.
IMPRESSION: Successful embolization was performed of the upper sac with a good angiographic result. CT is pending.