camsgram
Networker
Procedures Performed:
RHC
Bil Pulmonary angiography
Right Interlobal pulmonary embolism mechanical arterial extirpation of matter
Right TA pulmonary embolism mechanical arterial extirpation of matter
Right main PA pulmonary embolism mechanical arterial extirpation of matter
Left Posterior basal pulmonary embolism mechanical arterial extirpation of matter
Left superior segmental pulmonary embolism mechanical arterial extirpation of matter
Left main PA pulmonary embolism mechanical arterial extirpation of matter
Moderate sedation
US guided femoral vein access
Conclusions:
Bil saddle PE with RV strain. PESI score high risk.
Bil selective pulmonary angiogram done.
RHC: Mild pulmonary hypertension.
S/P thrombectomy to right and left pulmonary arteries and branches using Flash 16 penumbra aspiration system. 10cc of tPA was given selective in each pulmonary artery after using selective catheters.
Post thrombectomy, mean PA pressure improved from 24 to 15 mm Hg.
(Mod sed Start time xxxx End time xxxx & ITO provided)
Procedure Details:
Left lung injected, angiogram taken. Wire inserted and catheter exchanged, amplatz removed. Table J inserted sheath., table J removed; amplatz reinserted. 6Fr and 8Fr sheaths removed. 6Fr ang pig reinserted, amplatz wire removed, table J reinserted, table J removed. Coons dilator used to dilate up to 16 Fr sheath. 8Fr sheath exchanged for 16 Frx65cm sheath. Lighting thrombectomy catheter inserted. Catheter positioned in left lung. Aspirating left lung. Pulmonary arteries injected. Catheter repositioned into left lung; angiogram taken. Angiogram of left lung taken. Catheter positioned into right lung; angiogram taken. Oxygen increased to 5 L NC. Aspirating right lung. Pulmonary arteries injected. Total volume out 250ml. Thrombectomy catheter removed.
Intervention:
Therapeutic ACT was achieved with the administration of IV Heparin. 6Fr pigtail catheter was used to perform RHC. Using a flash 16 Rx aspiration system. Right pulmonary artery, right interlobal pulmonary artery and left pulmonary artery thrombectomy was performed. The catheter was advanced into segment and subsegmental branches. Significant amount of clot was aspirated. 10cc of tPA injected selectively in each main pulmonary artery for a total of 20cc.
Don't think RHC or US guidance can be coded. Totally confused on this one.
Any help is appreciated
36014 50
36015 50
37184
37185 RT x3
37185 LT x3
75743 26
75774 26,59
99152
RHC
Bil Pulmonary angiography
Right Interlobal pulmonary embolism mechanical arterial extirpation of matter
Right TA pulmonary embolism mechanical arterial extirpation of matter
Right main PA pulmonary embolism mechanical arterial extirpation of matter
Left Posterior basal pulmonary embolism mechanical arterial extirpation of matter
Left superior segmental pulmonary embolism mechanical arterial extirpation of matter
Left main PA pulmonary embolism mechanical arterial extirpation of matter
Moderate sedation
US guided femoral vein access
Conclusions:
Bil saddle PE with RV strain. PESI score high risk.
Bil selective pulmonary angiogram done.
RHC: Mild pulmonary hypertension.
S/P thrombectomy to right and left pulmonary arteries and branches using Flash 16 penumbra aspiration system. 10cc of tPA was given selective in each pulmonary artery after using selective catheters.
Post thrombectomy, mean PA pressure improved from 24 to 15 mm Hg.
(Mod sed Start time xxxx End time xxxx & ITO provided)
Procedure Details:
Left lung injected, angiogram taken. Wire inserted and catheter exchanged, amplatz removed. Table J inserted sheath., table J removed; amplatz reinserted. 6Fr and 8Fr sheaths removed. 6Fr ang pig reinserted, amplatz wire removed, table J reinserted, table J removed. Coons dilator used to dilate up to 16 Fr sheath. 8Fr sheath exchanged for 16 Frx65cm sheath. Lighting thrombectomy catheter inserted. Catheter positioned in left lung. Aspirating left lung. Pulmonary arteries injected. Catheter repositioned into left lung; angiogram taken. Angiogram of left lung taken. Catheter positioned into right lung; angiogram taken. Oxygen increased to 5 L NC. Aspirating right lung. Pulmonary arteries injected. Total volume out 250ml. Thrombectomy catheter removed.
Intervention:
Therapeutic ACT was achieved with the administration of IV Heparin. 6Fr pigtail catheter was used to perform RHC. Using a flash 16 Rx aspiration system. Right pulmonary artery, right interlobal pulmonary artery and left pulmonary artery thrombectomy was performed. The catheter was advanced into segment and subsegmental branches. Significant amount of clot was aspirated. 10cc of tPA injected selectively in each main pulmonary artery for a total of 20cc.
Don't think RHC or US guidance can be coded. Totally confused on this one.
Any help is appreciated
36014 50
36015 50
37184
37185 RT x3
37185 LT x3
75743 26
75774 26,59
99152