suela923@aol.com
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I attempted to bill 75774 for the views of the bladder, my reasoning was that Dr. Z's book states: Code 75736 is used to image pelvic structures (e.g. the uterus or bladder) pg. 138 Interventional Radiology Reference. I billed as an additional after basic because I already billed for a right and left internal illiac. Would anyone else out there bill for the bladder?
Thanks!
Sue
Pelvic angiogram
History: Motorcycle accident. A pelvic hematoma with extravasation of contrast was demonstrated on the CT examination of the abdomen and pelvis. I have been asked to perform pelvic angiography and potential embolization. I have discussed this procedure and associated risks with the patient, his wife and daughter. Risks include but are not limited to bleeding, embolism, nontarget embolization. The patient's wife understands that there is a risk of impotence if the embolization procedure is performed.
Patient was placed on the angiography table. He was prepped and draped in the usual sterile fashion. Timeout procedure was performed. Lidocaine was used for local anesthesia. Right common femoral artery was percutaneously accessed using micropuncture set. A 6-French sheath was inserted. Pigtail catheter advanced into the infrarenal aorta and an AP pelvic arteriogram performed. This catheter was then exchanged for a selective visceral catheter and each internal iliac artery was selectively catheterized and DSA images were obtained. On the right side additional selective angiography was performed in the anterior and posterior divisions of the internal iliac artery. The obturator artery and pudendal artery were selectively catheterized with angiographic images obtained.
No arterial injury was demonstrated. There was no extravasation of contrast, AV fistula or pseudoaneurysm formation demonstrated. During this procedure the patient's indwelling Foley catheter was clamped which allowed the bladder to become distended with contrast. AP and both oblique views of the bladder were obtained and demonstrated no evidence of extravasation. There was medial displacement of the bladder by bilateral pelvic hematomas.
No fractures were demonstrated.
Thanks!
Sue
Pelvic angiogram
History: Motorcycle accident. A pelvic hematoma with extravasation of contrast was demonstrated on the CT examination of the abdomen and pelvis. I have been asked to perform pelvic angiography and potential embolization. I have discussed this procedure and associated risks with the patient, his wife and daughter. Risks include but are not limited to bleeding, embolism, nontarget embolization. The patient's wife understands that there is a risk of impotence if the embolization procedure is performed.
Patient was placed on the angiography table. He was prepped and draped in the usual sterile fashion. Timeout procedure was performed. Lidocaine was used for local anesthesia. Right common femoral artery was percutaneously accessed using micropuncture set. A 6-French sheath was inserted. Pigtail catheter advanced into the infrarenal aorta and an AP pelvic arteriogram performed. This catheter was then exchanged for a selective visceral catheter and each internal iliac artery was selectively catheterized and DSA images were obtained. On the right side additional selective angiography was performed in the anterior and posterior divisions of the internal iliac artery. The obturator artery and pudendal artery were selectively catheterized with angiographic images obtained.
No arterial injury was demonstrated. There was no extravasation of contrast, AV fistula or pseudoaneurysm formation demonstrated. During this procedure the patient's indwelling Foley catheter was clamped which allowed the bladder to become distended with contrast. AP and both oblique views of the bladder were obtained and demonstrated no evidence of extravasation. There was medial displacement of the bladder by bilateral pelvic hematomas.
No fractures were demonstrated.
