armedical
Contributor
Looking for 2nd opinion on coding; 
We coded 36245-LT, 36246-RT, 75716-26, 75625-26
Date of Procedure 09/01/2013
Procedure: Aortogram w/runoff and selective bilateral iliac distal leg runoff.
Indication: Bilateral claaudication w/ABI of 0.7 on the left.
Procedures Performed: Aortogram & Selective cannulation of the iliacs from the radial position and runoff to both legs bilaterally.
Procedure Description: The patient was brought to th ecardiac cath lab, prepped and draped in sterile fashion. 1% lidocaine was used to infiltrate the right radial artery. A 6-French side-arm sheath for modified Seldinger technique was placed in the right radial artery. I then took a 5-french 100cm pigtail and performed digital subtraction angiography in AP position of the abdomen and iliac. I then removed the pigtail and placed 135 cm Quick-Cross and used a 260 cm Glidewire to selectively cannulate the right common femoral and placed the catheter at the point and did runoff to the foot of the right leg. I then manipulated the catheter into the right common femoral and performed angiography of the left system runoff.
Results: Results of diagnostic angio are as follows: The patient's aortogram showed mild to moderate disease with a distal aortic aneurysm seen with patent iliacs, internal, external, bilaterally, patent renal arteries bilaterally. The aneurysm appeared to be between 4.5 and 5 cm in diameter. The right leg is as follows: The common femoral is patent. The SFA is patent with mild diffuse disease and profunda is patent. The popliteal is patent. There is a 2-vessel runoff with patent TP trunk. There is a high-grade ostial anterior tibial stenoses with a patent posterior tibial and peroneal artery. The left leg shows mild to moderate disease of the SFA and patent profunda, patent popliteal. The left appeared to have a subtotally occluded anterior tibial, a patent peroneal and an occluded posterior tibial. Case was concluded at this time with a TR band to the right radial artery.
Impression : This patient has an obdominal aortic aneurysm and sevenre peripheral vascular disease in the left with 1-vesswel runoff of the left leg, left foot, infrapopiteal and 2-vessel runoff infrapopliteal of the right.
Recommentation: The paient will be sent for a CT scan to better size her aortic aneurysm and see if she is a candiate for stent graft.
We coded 36245-LT, 36246-RT, 75716-26, 75625-26
Date of Procedure 09/01/2013
Procedure: Aortogram w/runoff and selective bilateral iliac distal leg runoff.
Indication: Bilateral claaudication w/ABI of 0.7 on the left.
Procedures Performed: Aortogram & Selective cannulation of the iliacs from the radial position and runoff to both legs bilaterally.
Procedure Description: The patient was brought to th ecardiac cath lab, prepped and draped in sterile fashion. 1% lidocaine was used to infiltrate the right radial artery. A 6-French side-arm sheath for modified Seldinger technique was placed in the right radial artery. I then took a 5-french 100cm pigtail and performed digital subtraction angiography in AP position of the abdomen and iliac. I then removed the pigtail and placed 135 cm Quick-Cross and used a 260 cm Glidewire to selectively cannulate the right common femoral and placed the catheter at the point and did runoff to the foot of the right leg. I then manipulated the catheter into the right common femoral and performed angiography of the left system runoff.
Results: Results of diagnostic angio are as follows: The patient's aortogram showed mild to moderate disease with a distal aortic aneurysm seen with patent iliacs, internal, external, bilaterally, patent renal arteries bilaterally. The aneurysm appeared to be between 4.5 and 5 cm in diameter. The right leg is as follows: The common femoral is patent. The SFA is patent with mild diffuse disease and profunda is patent. The popliteal is patent. There is a 2-vessel runoff with patent TP trunk. There is a high-grade ostial anterior tibial stenoses with a patent posterior tibial and peroneal artery. The left leg shows mild to moderate disease of the SFA and patent profunda, patent popliteal. The left appeared to have a subtotally occluded anterior tibial, a patent peroneal and an occluded posterior tibial. Case was concluded at this time with a TR band to the right radial artery.
Impression : This patient has an obdominal aortic aneurysm and sevenre peripheral vascular disease in the left with 1-vesswel runoff of the left leg, left foot, infrapopiteal and 2-vessel runoff infrapopliteal of the right.
Recommentation: The paient will be sent for a CT scan to better size her aortic aneurysm and see if she is a candiate for stent graft.