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Can anyone confirm for me cath access and what to bill for the access? I am getting better and peripheral coding but still struggling. For some reason the office I am in has never used some cath entrance codes that I see from reports should clearly be used. Here is the report and I believe I should code 36200 for cath entrance, 75625 for abdominal runoff. Do you agree or am I missing anything? I also feel my reports are not completed in full sometimes making it very hard to code properly. Thank you in advance for your help!
PREPROCEDURE DIAGNOSIS
POSTPROCEDURE DIAGNOSIS
PROCEDURE PERFORMED
Aortogram with bilateral runoff.
HISTORY
The patient had a recent lower extremity ultrasound, which disclosed 80% right
common femoral artery stenosis brought in today for aortogram with bilateral
runoff.
EQUIPMENT USED
4-French Universal catheter, 4-French sheath, 0.035 Glidewire
ANESTHESIA
Versed and fentanyl for conscious sedation.
COMPLICATIONS
None.
PROCEDURE
Under sterile technique the left femoral site was prepped and draped. 1%
lidocaine was used for local anesthesia. Modified Seldinger approach used for
arterial cannulation and over-the-wire technique was used for all sheath and
catheter exchanges.
FINDINGS
Abdominal aortogram demonstrated normal contour to the abdomen with normal
bilateral renal arteries. No evidence of atherosclerosis or aneurysm,
bilateral common iliac arteries were angiographically normal in appearance.
They gave rise to an external and internal branch bilaterally, which were
angiographically normal in appearance. Selective views of the left lower
extremity showed angiographically normal. Common femoral artery, bifurcating
into an angiographically normal profunda femoris, and superficial femoral
artery. Popliteal and 3-vessel runoff were normal on the left. Selective views
of the right lower extremity demonstrated normal appearance of the common
femoral artery with no evidence of atherosclerosis or narrowing. It gave rise
to a profunda and superficial femoral artery that were angiographically normal
in appearance. The popliteal was angiographically normal in appearance and
there was 3-vessel runoff noted to the foot. After final pictures, the sheath
was removed and manual pressure was applied for hemostasis. The patient was
felt stable for discharge home after discharge criteria met.
IMPRESSION
Normal aortogram with bilateral runoff and hyperlipidemia.
PREPROCEDURE DIAGNOSIS
POSTPROCEDURE DIAGNOSIS
PROCEDURE PERFORMED
Aortogram with bilateral runoff.
HISTORY
The patient had a recent lower extremity ultrasound, which disclosed 80% right
common femoral artery stenosis brought in today for aortogram with bilateral
runoff.
EQUIPMENT USED
4-French Universal catheter, 4-French sheath, 0.035 Glidewire
ANESTHESIA
Versed and fentanyl for conscious sedation.
COMPLICATIONS
None.
PROCEDURE
Under sterile technique the left femoral site was prepped and draped. 1%
lidocaine was used for local anesthesia. Modified Seldinger approach used for
arterial cannulation and over-the-wire technique was used for all sheath and
catheter exchanges.
FINDINGS
Abdominal aortogram demonstrated normal contour to the abdomen with normal
bilateral renal arteries. No evidence of atherosclerosis or aneurysm,
bilateral common iliac arteries were angiographically normal in appearance.
They gave rise to an external and internal branch bilaterally, which were
angiographically normal in appearance. Selective views of the left lower
extremity showed angiographically normal. Common femoral artery, bifurcating
into an angiographically normal profunda femoris, and superficial femoral
artery. Popliteal and 3-vessel runoff were normal on the left. Selective views
of the right lower extremity demonstrated normal appearance of the common
femoral artery with no evidence of atherosclerosis or narrowing. It gave rise
to a profunda and superficial femoral artery that were angiographically normal
in appearance. The popliteal was angiographically normal in appearance and
there was 3-vessel runoff noted to the foot. After final pictures, the sheath
was removed and manual pressure was applied for hemostasis. The patient was
felt stable for discharge home after discharge criteria met.
IMPRESSION
Normal aortogram with bilateral runoff and hyperlipidemia.