suela923@aol.com
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This was coded 36222, 75710 but I don't understand that. I don't see where the unilateral extremity angiogram comes in? I see the findings for the axillary but I'm not sure I agree that this is a true upper extremity angiogram.
Any thoughts?!?! Thanks! Sue
IR ANGIOGRAM UPPER EXTREMITY RIGHT
Exam Date: 07/18/2014
Exam Time: 5:38 PM
Procedure: Thoracic aortic arch angiogram. Selective catheterization of the innominate artery.
Indication: Right upper extremity claudication and presumed right subclavian artery stenosis.
Results: Patient was identified and brought to the Vascular Unit. The right groin was prepped and draped in the usual sterile fashion; 2% lidocaine was used to infiltrate the skin over the right femoral artery. An angiographic needle, wire, and 5-French sheath were then placed. A 90 cm pigtail catheter was then placed to the level of the ascending aortic arch. Using DSA and power injection, thoracic aortic arch angiography was performed. This catheter was then exchanged out for a Berenstein catheter, and the innominate artery was selected for additional views of the right subclavian and right common carotid artery. At the completion of the case, the catheter and sheath were removed, and pressure was held for 10 minutes without incident. The patient tolerated the procedure well and left in stable condition.
Findings are as follows: The ascending, transverse, and proximal descending aortic arch are patent without stenosis. The origin of the innominate artery has mild occlusive plaque present but no significant stenosis. The right common carotid artery appears to be patent. There appears to be a severe stenosis at the origin of the right subclavian artery. The right subclavian and axillary arteries otherwise appear to be patent. The left common carotid artery appears to be patent with mild occlusive plaque at its origin. The left subclavian artery appears to be patent as well. Left axillary artery is patent without stenosis.
IMPRESSION:
Mild occlusive plaque at the origin of the innominate artery and left common carotid artery. Severe stenosis at the origin of the right subclavian artery.
Any thoughts?!?! Thanks! Sue
IR ANGIOGRAM UPPER EXTREMITY RIGHT
Exam Date: 07/18/2014
Exam Time: 5:38 PM
Procedure: Thoracic aortic arch angiogram. Selective catheterization of the innominate artery.
Indication: Right upper extremity claudication and presumed right subclavian artery stenosis.
Results: Patient was identified and brought to the Vascular Unit. The right groin was prepped and draped in the usual sterile fashion; 2% lidocaine was used to infiltrate the skin over the right femoral artery. An angiographic needle, wire, and 5-French sheath were then placed. A 90 cm pigtail catheter was then placed to the level of the ascending aortic arch. Using DSA and power injection, thoracic aortic arch angiography was performed. This catheter was then exchanged out for a Berenstein catheter, and the innominate artery was selected for additional views of the right subclavian and right common carotid artery. At the completion of the case, the catheter and sheath were removed, and pressure was held for 10 minutes without incident. The patient tolerated the procedure well and left in stable condition.
Findings are as follows: The ascending, transverse, and proximal descending aortic arch are patent without stenosis. The origin of the innominate artery has mild occlusive plaque present but no significant stenosis. The right common carotid artery appears to be patent. There appears to be a severe stenosis at the origin of the right subclavian artery. The right subclavian and axillary arteries otherwise appear to be patent. The left common carotid artery appears to be patent with mild occlusive plaque at its origin. The left subclavian artery appears to be patent as well. Left axillary artery is patent without stenosis.
IMPRESSION:
Mild occlusive plaque at the origin of the innominate artery and left common carotid artery. Severe stenosis at the origin of the right subclavian artery.