|
#1
12-19-2008, 01:09 AM
|
|||
|
|||
seperate access in the same side can we code
Hi,
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. Procedure. 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. Aortoiliac segment. There is no significant atherosclerotic disease. Left leg. 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. Impression. Left superficial femoral and proximal popliteal artery occlusion extending over 8 cm. Primarily successful angioplasty.
__________________
Shirley CPC,CPC-H 
|
