csavage87
Guest
OPERATION(s):
1. Placement of a catheter in the left brachial artery from a right femoral
approach.
2. Abdominal aortogram.
3. Arch angiogram.
4. Left upper extremity angiogram.
5. Left lower extremity angiogram.
6. Additional selective angiogram.
7. Balloon angioplasty of the femoropopliteal segment on the right with a
6-mm cutting balloon.
DESCRIPTION OF OPERATION: The patient was brought to the cath lab and
placed under mild IV sedation. The right groin was prepped and draped in
the usual sterile fashion. Local anesthesia was instilled in the groin.
Micropuncture technique was used to access the femoral, and a 5-French
sheath was placed. OMNI FLUSH catheter was advanced in the abdominal aorta,
reformed, abdominal aortogram was obtained. Catheter was withdrawn to the
aortic bifurcation. Oblique films were obtained of the pelvis. We advanced
the catheter over the bifurcation into the common femoral artery on the
right. Right lower extremity runoff views were obtained. The stiff wire was
placed. A 6-French sheath was advanced into the distal external iliac. The
patient was heparinized with 3000 units heparin. We advanced the angled
Bernstein catheter beyond the high-grade stenosis in the common femoral
artery, did a pullback pressure measurement. There was a significant
gradient across this area. She had a previous attempted graft placement in
this groin. Balloon angioplasty of the common femoral artery was performed
with a cutting balloon, with prolonged inflation. We advanced the sheath
across the lesion after the balloon angioplasty. There was no gradient
across with a 6-French sheath crossing the area. There was a mild
dissection on completion but this was not flow limiting. Sheath was pulled
back to the aortic bifurcation. We advanced into the root of the aorta. LAO
arch angiogram was obtained. The pigtail catheter was then exchanged for a
Weinberg catheter which was placed into the proximal subclavian and upper
arm extra views were obtained. There was extremely sluggish flow and
significant motion artifact, therefore the catheter was advanced more
distally into the brachial artery in the antebrachial area and completion
views were obtained from here. The catheter and wire were removed over
sheath. StarClose device was deployed in the groin with good hemostasis.
The patient was transferred back to the cardiac outpatient unit in stable
condition.
In this situation where he did a left upper extremity and a left lower extremity angiography. Would you have to code 75710 and 75774 or can you code 75710 twice. Thanks!
1. Placement of a catheter in the left brachial artery from a right femoral
approach.
2. Abdominal aortogram.
3. Arch angiogram.
4. Left upper extremity angiogram.
5. Left lower extremity angiogram.
6. Additional selective angiogram.
7. Balloon angioplasty of the femoropopliteal segment on the right with a
6-mm cutting balloon.
DESCRIPTION OF OPERATION: The patient was brought to the cath lab and
placed under mild IV sedation. The right groin was prepped and draped in
the usual sterile fashion. Local anesthesia was instilled in the groin.
Micropuncture technique was used to access the femoral, and a 5-French
sheath was placed. OMNI FLUSH catheter was advanced in the abdominal aorta,
reformed, abdominal aortogram was obtained. Catheter was withdrawn to the
aortic bifurcation. Oblique films were obtained of the pelvis. We advanced
the catheter over the bifurcation into the common femoral artery on the
right. Right lower extremity runoff views were obtained. The stiff wire was
placed. A 6-French sheath was advanced into the distal external iliac. The
patient was heparinized with 3000 units heparin. We advanced the angled
Bernstein catheter beyond the high-grade stenosis in the common femoral
artery, did a pullback pressure measurement. There was a significant
gradient across this area. She had a previous attempted graft placement in
this groin. Balloon angioplasty of the common femoral artery was performed
with a cutting balloon, with prolonged inflation. We advanced the sheath
across the lesion after the balloon angioplasty. There was no gradient
across with a 6-French sheath crossing the area. There was a mild
dissection on completion but this was not flow limiting. Sheath was pulled
back to the aortic bifurcation. We advanced into the root of the aorta. LAO
arch angiogram was obtained. The pigtail catheter was then exchanged for a
Weinberg catheter which was placed into the proximal subclavian and upper
arm extra views were obtained. There was extremely sluggish flow and
significant motion artifact, therefore the catheter was advanced more
distally into the brachial artery in the antebrachial area and completion
views were obtained from here. The catheter and wire were removed over
sheath. StarClose device was deployed in the groin with good hemostasis.
The patient was transferred back to the cardiac outpatient unit in stable
condition.
In this situation where he did a left upper extremity and a left lower extremity angiography. Would you have to code 75710 and 75774 or can you code 75710 twice. Thanks!