Wiki Aortogram - confirm my codes

prabha

Guru
Messages
183
Best answers
0
36215
36215X6-59
75605-26
75650-26
75710-26
75705X6-26

Can anyone please confirm my codes for the below pocedure


Patient is a 60-year-old male with COPD exacerbation, intubated.
He now presents with massive hemoptysis, a witnessed episode of at
least 800 cc


The patient's right groin was prepped and draped in usual sterile
manner and locally anesthetized with 1% lidocaine. The right
common femoral artery was accessed with a micro-puncture site,
exchange made for a 6 French vascular sheath. A 5 French Omni
Flush catheter was advanced into the aortic arch. Digital
subtraction aortography was performed in 45? left anterior oblique
projection.

A Simmons 2 catheter was reformed over the aortic arch and used to
selectively catheterize the left subclavian artery. Digital
subtraction angiography was performed with injection into the left
subclavian artery.

Due to inability to identify any potential bleeding or abnormal
vessel, repeat aortography was performed this time with the
catheter in the descending thoracic aorta. The right-sided
intercostal bronchial trunk was identified, and selective
catheterization was performed using a 5 French Cobra catheter.

Exchange was then made for a Mickelson catheter and selective
catheterization was performed of multiple intercostal arteries
with contrast injection.

Findings:
All of the visualized injected vessels are unremarkable. Aortic
arch and descending thoracic aorta injection reveals no abnormal
area of hypervascularity in either lung field. The internal
mammary arteries are identified bilaterally, and are unremarkable
in appearance. Injection of the right intercostal bronchial trunk
is unremarkable as well, the vessel is not hypertrophied and this
does not appear to be a bleeding source. Numerous other
intercostal arteries were injected, also unremarkable in
appearance.

At the end of the procedure the catheter and sheath were removed
and hemostasis achieved with manual compression. No embolization
was performed, due to inability to find any abnormal, possibly
bleeding vessel.

Impression:
Arch aortagram, descending thoracic aortogram, left subclavian
artery arteriogram, as well as selective injections into the
intercostobronchial trunk and multiple intercostal arteries are
all unremarkable. No area of hypervascularity is identified and no
embolization was performed.
 
Slg

I did not check all of your codes, but there are a few things that stand out when reading the note. I noticed the phrase "All of the visualized injected vessels are unremarkable". I feel the vessels in particular that are being referred to should be listed.

I also did not see an interpretation for the Subclavian specifically.

How did you arrive at 75706 X 6 ?:confused:
 
Chest vs spine case

Hi

I would have coded 75726 instead of 76705. The patient has hempotysis not an issue with their spine. 75726 would be the correct code in a chest case
 
cath placements

I would be leary to code that many cath placements when the physician is not being clear on the number of intercostals he selectively engaged. That also will play part in how many angios (75726) you bill. (I agree with everyone's comments on the 75706 should be 75726)
 
Top