Wiki Am I correct if not please respond

[decus1956]

Need to make sure coding correctly:

DX: Carotid arterial disease, PVD and End stage renal disease

Procedure in detail:
Patient brought in cath lab. French sheath was inserted in RCFA. Following this, cath was advanced into AA and positioned, then AA arteriogram was performed. Following this, head hunter cath was used to selectively engage the RCCA and R. carotid arteriogram was performed. Then Head Hunter cath was used to selectively engage LCCA and L carotid arteriogram was performed. Caths were aspirated and flushed multiple times to reduce risk of thromboembolic events. Following this, pigtail cath was positioned in AA above iliac bifurcation. An AA was performed with bilateral iliac runoffs. Followng this pigtail chath was pulled back into the R common carotid and selective arteriogram of R iliac artery was performed. Then sheath was sewn in position and patient was taken to recovery room, pt tolerated procedure well.

I have 36216, 36215, 75630-26-59, and 36245. Is this correct?

 

[Jim Pawloski]

Need to make sure coding correctly:

DX: Carotid arterial disease, PVD and End stage renal disease

Procedure in detail:
Patient brought in cath lab. French sheath was inserted in RCFA. Following this, cath was advanced into AA and positioned, then AA arteriogram was performed. Following this, head hunter cath was used to selectively engage the RCCA and R. carotid arteriogram was performed. Then Head Hunter cath was used to selectively engage LCCA and L carotid arteriogram was performed. Caths were aspirated and flushed multiple times to reduce risk of thromboembolic events. Following this, pigtail cath was positioned in AA above iliac bifurcation. An AA was performed with bilateral iliac runoffs. Followng this pigtail chath was pulled back into the R common carotid and selective arteriogram of R iliac artery was performed. Then sheath was sewn in position and patient was taken to recovery room, pt tolerated procedure well.

I have 36216, 36215, 75630-26-59, and 36245. Is this correct?

I hate to say this, but not even close. The report is needed to see if just the common carotid was imaged, or was both neck and head was imaged.
Thanks,
Jim Pawloski, CIRCC, R.T. (CV)

 

[decus1956]

please help me understand this

Here is some more info:
Procedure in Summary. R. femoral arteriotomy, AA aortogram, Selective cannulation of RCCA w/R. carotid arteriogram, selective of LCCA w/L. carotid arteriogram, Abdominal aortogram, and selective R. iliac arteriogram.
Final Assessment: Normal AA configuration, 100% total occlusion of R and L internal carotid artery, L. vertebral appears occluded, r. vertebral artery is patent w/50% proximal stenosis just after origin from R. subclavian, diffuse calcific disease of AA. R iliac artery has narrowings in range of 50%, but no obstructive or critical lesions are detected. L iliac appears to be 70% stenosis in midportion of LCIA. There is diffuse disease throughout L and External iliac arteries, but no critical lesions.

Is this any help or do you need Lab findings also......

 

[Jim Pawloski]

Here is some more info:
Procedure in Summary. R. femoral arteriotomy, AA aortogram, Selective cannulation of RCCA w/R. carotid arteriogram, selective of LCCA w/L. carotid arteriogram, Abdominal aortogram, and selective R. iliac arteriogram.
Final Assessment: Normal AA configuration, 100% total occlusion of R and L internal carotid artery, L. vertebral appears occluded, r. vertebral artery is patent w/50% proximal stenosis just after origin from R. subclavian, diffuse calcific disease of AA. R iliac artery has narrowings in range of 50%, but no obstructive or critical lesions are detected. L iliac appears to be 70% stenosis in midportion of LCIA. There is diffuse disease throughout L and External iliac arteries, but no critical lesions.

Is this any help or do you need Lab findings also......

I would bill 36222-rt, 36222-lt, 36266-rt, 36225-lt, 75630-59.

HTH,
Jim Pawloski, CIRCC, R.T.(CV)