TWilliam2019
Guru
can some please help me with this.
36252 denied
I reviewed and now I am questioning if it should be 36253 RT and 36251 LT.
Any help is appreciated. thanks
Procedure Details:
After consent was obtained the patient was taken to the operative suite and laid in the supine position. The patient was placed under monitored anesthesia care and bilateral groins were prepped and draped in the usual sterile fashion. A proper timeout was performed and agreed upon by all parties present. Ultrasound was used to gain access to the right common femoral artery. Ultrasound-guided puncture was performed of the right common femoral artery using a micropuncture technique. Duplex was used to survey the site for vessel selection and puncture was performed under real-time ultrasound imaging. Imaging was documented of the guidance and placed in the patient's record. A wire was passed into the external iliac artery and a 5 French sheath was placed and flushed with heparinized saline. Universal flush catheter was guided over 0.035 wire into the abdominal aorta and an abdominal aortogram was performed.
AORTOGRAM FINDINGS:
The abdominal aorta appears patent. The bilateral common iliac, internal iliac, external iliac arteries are patent
The sheath is exchanged over the Glidewire for a 7 French tour guide sheath. The right inferior renal artery from a dual renal artery system was selected out with the wire and catheter and selective arteriogram was performed which showed patency of the inferior renal artery throughout without stenosis. The wire and sheath were withdrawn into the aorta and redirected into the superior right renal artery from the dual renal system and selected out. An arteriogram of the superior renal artery showed no evidence of stenosis. The catheter was withdrawn back into the aorta and directed towards the left renal artery which was selected out and selective arteriogram of the left renal artery showed no evidence of renal artery stenosis. The catheter was withdrawn back into the aorta and then guided over the wire into the right iliac artery. The sheath was exchanged for a 7 French by 10 cm sheath and flushed with heparinized saline. The access site was closed with a 7 FrenchExoseal. Hemostasis was achieved. The patient tolerated the procedure well instrument transition to the recovery area in stable condition.
36252 denied
I reviewed and now I am questioning if it should be 36253 RT and 36251 LT.
Any help is appreciated. thanks
Procedure Details:
After consent was obtained the patient was taken to the operative suite and laid in the supine position. The patient was placed under monitored anesthesia care and bilateral groins were prepped and draped in the usual sterile fashion. A proper timeout was performed and agreed upon by all parties present. Ultrasound was used to gain access to the right common femoral artery. Ultrasound-guided puncture was performed of the right common femoral artery using a micropuncture technique. Duplex was used to survey the site for vessel selection and puncture was performed under real-time ultrasound imaging. Imaging was documented of the guidance and placed in the patient's record. A wire was passed into the external iliac artery and a 5 French sheath was placed and flushed with heparinized saline. Universal flush catheter was guided over 0.035 wire into the abdominal aorta and an abdominal aortogram was performed.
AORTOGRAM FINDINGS:
The abdominal aorta appears patent. The bilateral common iliac, internal iliac, external iliac arteries are patent
The sheath is exchanged over the Glidewire for a 7 French tour guide sheath. The right inferior renal artery from a dual renal artery system was selected out with the wire and catheter and selective arteriogram was performed which showed patency of the inferior renal artery throughout without stenosis. The wire and sheath were withdrawn into the aorta and redirected into the superior right renal artery from the dual renal system and selected out. An arteriogram of the superior renal artery showed no evidence of stenosis. The catheter was withdrawn back into the aorta and directed towards the left renal artery which was selected out and selective arteriogram of the left renal artery showed no evidence of renal artery stenosis. The catheter was withdrawn back into the aorta and then guided over the wire into the right iliac artery. The sheath was exchanged for a 7 French by 10 cm sheath and flushed with heparinized saline. The access site was closed with a 7 FrenchExoseal. Hemostasis was achieved. The patient tolerated the procedure well instrument transition to the recovery area in stable condition.