marcumyj
Contributor
Can someone help to make sure I have this:
1. Left heart catheterization.
2. Selective coronary angiography.
3. Left ventricular catheter placement.
4. Left ventriculography.
5. Right brachiocephalic trunk angiography.
6. Left subclavian angiography.
7. Retrograde right common femoral angiography.
INDICATIONS FOR PROCEDURE:
1. Unstable angina symptoms
2. Diabetes.
3. Hypertension.
DETAILS OF PROCEDURE: The patient was brought to the catheterization lab in
a postabsorptive state as a transfer from the emergency room.
In summary, the patient came in today with a picture consistent with
stuttering angina for the last one-and-a-half to two weeks. Given this, he
was transferred to the catheterization lab for diagnostic angiography. The
right groin was prepped and draped in normal sterile fashion. Lidocaine 2%
was used for local anesthesia. An 18-gauge needle was used to puncture the
right common femoral artery via single anterior wall puncture. Via modified
Seldinger technique, a 5-French sheath was advanced over a wire into the
artery. Next, a JL4 catheter was advanced over a wire and used to engage the
left main coronary artery and image the left coronary system in multiple
views. This catheter was then exchanged for a 3DRC catheter, which was used
to engage the right main coronary artery and image the right coronary system
in multiple views. This catheter was then subsequently pulled back to the
level of the right brachiocephalic trunk and a brachiocephalic angiogram was
performed given a blood pressure discrepancy in the emergency room between
the right and left arms. This catheter was then subsequently pulled back to
the left subclavian. Another angiography was performed given the blood
pressure discrepancy. This catheter was then subsequently removed over a
wire. Next, a pigtail catheter was advanced over a wire and used to engage
the left ventricle. An LVEDP was obtained. A hand injection was performed
in the LV. This catheter was subsequently pulled across the valve to assess
for gradient. There was no gradient. This catheter was then subsequently
removed over a wire. Next, we performed a retrograde right common femoral
angiogram to assess access level. The patient's sheath was pulled in the
catheterization lab and manual pressure applied per protocol. The patient
will be admitted overnight for post-catheterization care and further pursuit
of his chest pain.
I came up with
93510-26
93543
93545
93555 26/59
G0278
36215 RT
36215 LT
75680
The physician has stated:
93510-26
93545
93556-26
93543
93555
36245
36245-59
75724-26/59
Help and thanks for the time
1. Left heart catheterization.
2. Selective coronary angiography.
3. Left ventricular catheter placement.
4. Left ventriculography.
5. Right brachiocephalic trunk angiography.
6. Left subclavian angiography.
7. Retrograde right common femoral angiography.
INDICATIONS FOR PROCEDURE:
1. Unstable angina symptoms
2. Diabetes.
3. Hypertension.
DETAILS OF PROCEDURE: The patient was brought to the catheterization lab in
a postabsorptive state as a transfer from the emergency room.
In summary, the patient came in today with a picture consistent with
stuttering angina for the last one-and-a-half to two weeks. Given this, he
was transferred to the catheterization lab for diagnostic angiography. The
right groin was prepped and draped in normal sterile fashion. Lidocaine 2%
was used for local anesthesia. An 18-gauge needle was used to puncture the
right common femoral artery via single anterior wall puncture. Via modified
Seldinger technique, a 5-French sheath was advanced over a wire into the
artery. Next, a JL4 catheter was advanced over a wire and used to engage the
left main coronary artery and image the left coronary system in multiple
views. This catheter was then exchanged for a 3DRC catheter, which was used
to engage the right main coronary artery and image the right coronary system
in multiple views. This catheter was then subsequently pulled back to the
level of the right brachiocephalic trunk and a brachiocephalic angiogram was
performed given a blood pressure discrepancy in the emergency room between
the right and left arms. This catheter was then subsequently pulled back to
the left subclavian. Another angiography was performed given the blood
pressure discrepancy. This catheter was then subsequently removed over a
wire. Next, a pigtail catheter was advanced over a wire and used to engage
the left ventricle. An LVEDP was obtained. A hand injection was performed
in the LV. This catheter was subsequently pulled across the valve to assess
for gradient. There was no gradient. This catheter was then subsequently
removed over a wire. Next, we performed a retrograde right common femoral
angiogram to assess access level. The patient's sheath was pulled in the
catheterization lab and manual pressure applied per protocol. The patient
will be admitted overnight for post-catheterization care and further pursuit
of his chest pain.
I came up with
93510-26
93543
93545
93555 26/59
G0278
36215 RT
36215 LT
75680
The physician has stated:
93510-26
93545
93556-26
93543
93555
36245
36245-59
75724-26/59
Help and thanks for the time