Wiki Subclavian Stent

amym

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Loganville, GA
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Would it be appropriate to code this as:


37205 / 36215 / 75710 / 75625


PROCEDURE: Arch aortography, balloon angioplasty, percutaneous transluminal angioplasty of the left subclavian artery, stenting of the left subclavian artery. Distal part of the wire was parked up to the axillary artery.

Access obtained in the right common femoral artery using a 5-French sheath. After that a wire was advanced in the arch of aorta, and a pigtail catheter was advanced along with it. An aortogram was taken using the power injector which revealed 80% - 90% stenosis of the left subclavian artery with a good landing zone proximally and distally, with no involvement of either the left internal mammary artery or the left vertebral artery.

After the diagnosis was established, a stiff angled glide was exchanged and was used to cross the lesion. After that a 4-French vertebral catheter was advanced over a 3.5 stiff angled Glidewire and used to cross the lesion. After that we withdrew the stiff angled glide, and a 0.035 Supercore wire was advanced, and that wire was advanced up to the level of the axillary artery, after that the vertebral artery and the 5-French sheath was removed. Then the 80 cm 7-French sheath was advanced, and the sheath was parked just proximal to the left subclavian artery. 5000 units of heparin was administered. After that a 6.0 x 20 PTA catheter, FoxCross, was used to initially dilate the lesion with suboptialm angiographic results. The balloon was withdrawn and a balloon expandable Cordis 7 x 39 Genesis catheter was used and placed under agnographic guidance. After that was removed, a 7 x French long sheath was exchanged for a short 8French sheath.
 
Would it be appropriate to code this as:


37205 / 36215 / 75710 / 75625


PROCEDURE: Arch aortography, balloon angioplasty, percutaneous transluminal angioplasty of the left subclavian artery, stenting of the left subclavian artery. Distal part of the wire was parked up to the axillary artery.

Access obtained in the right common femoral artery using a 5-French sheath. After that a wire was advanced in the arch of aorta, and a pigtail catheter was advanced along with it. An aortogram was taken using the power injector which revealed 80% - 90% stenosis of the left subclavian artery with a good landing zone proximally and distally, with no involvement of either the left internal mammary artery or the left vertebral artery.

After the diagnosis was established, a stiff angled glide was exchanged and was used to cross the lesion. After that a 4-French vertebral catheter was advanced over a 3.5 stiff angled Glidewire and used to cross the lesion. After that we withdrew the stiff angled glide, and a 0.035 Supercore wire was advanced, and that wire was advanced up to the level of the axillary artery, after that the vertebral artery and the 5-French sheath was removed. Then the 80 cm 7-French sheath was advanced, and the sheath was parked just proximal to the left subclavian artery. 5000 units of heparin was administered. After that a 6.0 x 20 PTA catheter, FoxCross, was used to initially dilate the lesion with suboptialm angiographic results. The balloon was withdrawn and a balloon expandable Cordis 7 x 39 Genesis catheter was used and placed under agnographic guidance. After that was removed, a 7 x French long sheath was exchanged for a short 8French sheath.

I think you have 36221, 36215, 37205, 75960. No extremity angio was performed.
HTH,
Jim Pawloski, CIRCC
 
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