csavage87
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DESCRIPTION OF PROCEDURE:
The right femoral artery was cleaned and draped in the usual sterile fashion. Access was obtained via the Seldinger technique. Despite multiple attempts and fluid bolusing and Valsalva, the right femoral vein was not accessed. JR-4 was advanced to the ascending aorta, across the aorta. The LV pressure was 210/20. Aortic pressure was 140/81. The mean aortic valve gradient was 45 mmHg. Right coronary artery was noted to be occluded to the left main. The left anterior descending (LAD) was occluded proximally. The circumflex had a 30-40 percent stenosis. The proximal obtuse marginal (OM) branches were occluded. The distal vessel had luminal irregularities of 23 percent. The sequential free internal mammary to the posterior descending artery (PDA) was patent. The left radial to obtuse marginal 1 (OM-1) and obtuse marginal 2 (OM-2) were the most patent.
With this description, is it possible to bill for a Right Heart Cath with reduced services. Or would you not bill for the RHC because the right heart was never successfully accessed?
The right femoral artery was cleaned and draped in the usual sterile fashion. Access was obtained via the Seldinger technique. Despite multiple attempts and fluid bolusing and Valsalva, the right femoral vein was not accessed. JR-4 was advanced to the ascending aorta, across the aorta. The LV pressure was 210/20. Aortic pressure was 140/81. The mean aortic valve gradient was 45 mmHg. Right coronary artery was noted to be occluded to the left main. The left anterior descending (LAD) was occluded proximally. The circumflex had a 30-40 percent stenosis. The proximal obtuse marginal (OM) branches were occluded. The distal vessel had luminal irregularities of 23 percent. The sequential free internal mammary to the posterior descending artery (PDA) was patent. The left radial to obtuse marginal 1 (OM-1) and obtuse marginal 2 (OM-2) were the most patent.
With this description, is it possible to bill for a Right Heart Cath with reduced services. Or would you not bill for the RHC because the right heart was never successfully accessed?
