cardiology101
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Another new one....Need help coding
PROCEDURE: PERIPHERAL ANGIOGRAM.
DESCRIPTION PROCEDURE: Adequate IV sedation. Lidocaine into right groin. Seldinger
technique 6 french sheath placed in common femoral artery
w.o complications. Exchanges done over wire, first pigtail
place din aorta and aortogram was performed of renal
and infrarenal aorta. Pigtail pulled back and nonselective
bollus chase method used to perform angiograms of both
legs. Selective angiogram of left leg perfromed using a VS
catheter to engage left common iliac. Microcatheter was
placed and selective angiograms of common femoral as well
as popliteal were performed w/ microcatheter as distal
as the distal SFA.
PROCEDURES DONE: AORTOBIFEMORAL ANGIOGRAM W. NONSELECTIVE ANGIOGRAM
BOTH LEGS
SELECTIVE ANGIOGRAM L/LEG W/SELECTIVE ANGIOGRAM OF
FEMORAL POPLITEAL BYPASS GRAFT W/CATHETER IN LEFT
BYPASS GRAFT.
PTCA/ANGIOPLASTY OF PROXIMAL LESION OF FEMORAL
POPLITEAL BYPASS
PTCA/ANGIOPLASTY OF PROXIMAL 70% OCCULSION OF
POPLITEAL ARTERY, LEFT.
INTERVENTIONAL PROCEDURE/ANATOMY: Aortogram demonstrated patent bilateral
renal arteries 40-50% proximal l/renal
stenosis, bilateral access revealerenal
artery supplying lower lobe which is free
of disease. Infrrenal aorta mild disease.
It bifurcates into common ilian system
bilaterally. On the right, right common
bifurcates into common iliac bilaterally.
Right internal ilian has ostia 90% lesion.
RIght external ilian is patent w/mild disease.
Right SFA occluded and fills retrograde. No
bypass graft was bisulized. Extensive
collateralization form deep system and
supplies below knee amputation. Left side
left common iliac is patent. Left external
and internal iliac are patent. Left SFA is
occluded and has a fem pop bypass graft,
which retrograde fills distal SFA. The
promal/ostial portion of the fem pop bypass
graft has eccentric 80% lesion. Popliteal has
two sequential lesions a proximal 70-80%
lesion followed by more distal 50% lesion.
Only one vessel runoff of the infropopliteal
region w/anterior tibial which supplies the foot.
Proximal 70% lesion in the anterior tibial, small
vessel. Posterior tibial and the tibial peroneal
peroneal trunk is occluded. Extensive
collateralization.
As always your help is greatly appreciate.
PROCEDURE: PERIPHERAL ANGIOGRAM.
DESCRIPTION PROCEDURE: Adequate IV sedation. Lidocaine into right groin. Seldinger
technique 6 french sheath placed in common femoral artery
w.o complications. Exchanges done over wire, first pigtail
place din aorta and aortogram was performed of renal
and infrarenal aorta. Pigtail pulled back and nonselective
bollus chase method used to perform angiograms of both
legs. Selective angiogram of left leg perfromed using a VS
catheter to engage left common iliac. Microcatheter was
placed and selective angiograms of common femoral as well
as popliteal were performed w/ microcatheter as distal
as the distal SFA.
PROCEDURES DONE: AORTOBIFEMORAL ANGIOGRAM W. NONSELECTIVE ANGIOGRAM
BOTH LEGS
SELECTIVE ANGIOGRAM L/LEG W/SELECTIVE ANGIOGRAM OF
FEMORAL POPLITEAL BYPASS GRAFT W/CATHETER IN LEFT
BYPASS GRAFT.
PTCA/ANGIOPLASTY OF PROXIMAL LESION OF FEMORAL
POPLITEAL BYPASS
PTCA/ANGIOPLASTY OF PROXIMAL 70% OCCULSION OF
POPLITEAL ARTERY, LEFT.
INTERVENTIONAL PROCEDURE/ANATOMY: Aortogram demonstrated patent bilateral
renal arteries 40-50% proximal l/renal
stenosis, bilateral access revealerenal
artery supplying lower lobe which is free
of disease. Infrrenal aorta mild disease.
It bifurcates into common ilian system
bilaterally. On the right, right common
bifurcates into common iliac bilaterally.
Right internal ilian has ostia 90% lesion.
RIght external ilian is patent w/mild disease.
Right SFA occluded and fills retrograde. No
bypass graft was bisulized. Extensive
collateralization form deep system and
supplies below knee amputation. Left side
left common iliac is patent. Left external
and internal iliac are patent. Left SFA is
occluded and has a fem pop bypass graft,
which retrograde fills distal SFA. The
promal/ostial portion of the fem pop bypass
graft has eccentric 80% lesion. Popliteal has
two sequential lesions a proximal 70-80%
lesion followed by more distal 50% lesion.
Only one vessel runoff of the infropopliteal
region w/anterior tibial which supplies the foot.
Proximal 70% lesion in the anterior tibial, small
vessel. Posterior tibial and the tibial peroneal
peroneal trunk is occluded. Extensive
collateralization.
As always your help is greatly appreciate.