I am failry new to Cardiology coding and was wondering if someone could help me code this. The date of service is 2012.
Thanks.
Lisa, CPC
PROCEDURES:
1. Left popliteal venotomy, antegrade to flow, with ultrasound guidance.
2. Left popliteal venogram with runoff.
3. Aspiration thrombectomy of the left SFA and iliac veins.
4. Thrombolytic therapy and thrombectomy of the left saphenous vein and iliac vein with the trellis device.
5. Balloon angioplasty of the distal inferior vena cava, left iliac vein, and left greater saphenous vein.
6. Manual hemostasis.
FINDINGS:
1. Left saphenous vein occluded with thrombus down to the popliteal vein.
2. Left iliac vein occluded with thrombus in its entirety.
3. Left popliteal vein widely patent.
INTERVENTION:
1. Aspiration atherectomy of the iliac vein and the saphenous vein with multiple passes.
2. Localized thrombolysis and thrombectomy in the saphenous vein and the iliac vein in multiple positions with the Trellis thrombectomy device.
3. Balloon angioplasty of the distal inferior vena cava, the left iliac vein, and the left proximal saphenous vein in multiple positions with multiple balloons: A 14 mm balloon in the IVC and the proximal iliac vein, a 10 mm balloon distal to that.
4. Marked improvement, but still residual thrombus proximally, but with no further improvement with continued thrombectomy efforts.
ANTICOAGULATION:
1. Heparin 4000 units, plus 2000 units.
2. Thrombolytic therapy with rtPA into the Trellis system during thrombolysis for thrombectomy.
3. ACT 177 at end of procedure.
HEMOSTASIS:
Manual compression over the left popliteal vein in the cath lab.
COMPLICATIONS:
None immediately apparent.
TECHNICAL NOTES, MODIFIERS, COMORBIDITIES:
1. The patient has lymphoma, and appears to have some hypercoagulability secondary to that.
2. This procedure was lengthy, required the patient be prone throughout. Very uncomfortable and difficult for the patient (about 3 hours prone).
Thanks.
Lisa, CPC
PROCEDURES:
1. Left popliteal venotomy, antegrade to flow, with ultrasound guidance.
2. Left popliteal venogram with runoff.
3. Aspiration thrombectomy of the left SFA and iliac veins.
4. Thrombolytic therapy and thrombectomy of the left saphenous vein and iliac vein with the trellis device.
5. Balloon angioplasty of the distal inferior vena cava, left iliac vein, and left greater saphenous vein.
6. Manual hemostasis.
FINDINGS:
1. Left saphenous vein occluded with thrombus down to the popliteal vein.
2. Left iliac vein occluded with thrombus in its entirety.
3. Left popliteal vein widely patent.
INTERVENTION:
1. Aspiration atherectomy of the iliac vein and the saphenous vein with multiple passes.
2. Localized thrombolysis and thrombectomy in the saphenous vein and the iliac vein in multiple positions with the Trellis thrombectomy device.
3. Balloon angioplasty of the distal inferior vena cava, the left iliac vein, and the left proximal saphenous vein in multiple positions with multiple balloons: A 14 mm balloon in the IVC and the proximal iliac vein, a 10 mm balloon distal to that.
4. Marked improvement, but still residual thrombus proximally, but with no further improvement with continued thrombectomy efforts.
ANTICOAGULATION:
1. Heparin 4000 units, plus 2000 units.
2. Thrombolytic therapy with rtPA into the Trellis system during thrombolysis for thrombectomy.
3. ACT 177 at end of procedure.
HEMOSTASIS:
Manual compression over the left popliteal vein in the cath lab.
COMPLICATIONS:
None immediately apparent.
TECHNICAL NOTES, MODIFIERS, COMORBIDITIES:
1. The patient has lymphoma, and appears to have some hypercoagulability secondary to that.
2. This procedure was lengthy, required the patient be prone throughout. Very uncomfortable and difficult for the patient (about 3 hours prone).