seperate access in the same side can we code
Sorry i think iam the one who putting this much big big reports.
My doubt here is
1)in this report can we code 2 angioplasty (angioplasty SFA and popliteal)
2)can we code 36200-59 for diagnostic angiogram access and intervention is a seperate access on the same side upto popliteal from common femoral 36246.
Informed consent was obtained. The patient was prepped and draped
appropriately and after infiltration with local anesthesia the
left common femoral artery was punctured with a 19 gauge needle
and a Newton J wire advanced into the abdominal aorta where an
exchange was made for a 4 French omni flush catheter through which
contrast was injected. The catheter was then pulled down to the
left external iliac artery and further injections performed with
filming down the left leg.
There is no significant atherosclerotic disease.
There is a mild stenosis in the distal common femoral artery
proximal to the takeoff of the profunda. The superficial femoral
artery is patent to the distal adductor canal where it is stenotic
over 5 cm and then there is a short segment occlusion in the
proximal popliteal artery. The popliteal artery reconstitutes
above the knee joint and there is 3-vessel runoff to the ankle.
Left superficial femoral artery angioplasty.
The previously placed catheter was removed and compression
applied. After infiltration with local anesthesia an antegrade
puncture was performed with a micropuncture set to introduce a
5-French sheath. Over the wire, a Berenstein catheter was
introduced and a Terumo used to cross the stenosis and the
occlusion. An exchange was then made over a Rosen wire for a 5-mm
balloon catheter 4 cm in length. After balloon inflation,
contrast injection through the sheath demonstrated two residual
stenoses and the balloon was reintroduced. After a second
inflation contrast injection through the side-arm of the sheath
after the balloon was removed demonstrated a good cosmetic result
and no change in the runoff.
Left superficial femoral and proximal popliteal artery occlusion
extending over 8 cm. Primarily successful angioplasty.