claning
Networker
Hello fellow coders!
Our hospital coder (coding for professional charges) wants to code both non-selective 36221 and selective 36216 for the arch aortogram...they also did an injection of nitriglycerin in the extremity. I'm thinking 36216, 75710, 96373 (??) & 75625? I need to do more Head & Neck!
Please see below report and share your thoughts, thanks!
Procedure: Arch aortogram, selective left upper extremity arteriogram with the catheter in the axillary artery, intra-arterial infusion of radioactive drug.
After full examination of risks and benefits of the procedure informed consent was obtained. Both groins were sterilely prepared and draped. The right common femoral artery was punctured under ultrasound guidance and a 5 French sheath was inserted. A pigtail catheter was advanced into the ascending aorta and an arch aortogram was done. The left subclavian artery was then selected and a Davis catheter advanced into the axillary artery. A left upper extremity arteriogram was done. 100 mcg of nitroglycerin was then injected intra-arterially and repeat angiogram of the hand was performed. Catheters and wires were removed and access site closed using an Angio-Seal device.
Findings: The arch aorta is widely patent with no evidence of atherosclerotic disease in the angiogram. The visualized portions of both common carotid arteries and the right subclavian artery are patent. Flow in both vertebral arteries is antegrade.
Selective left upper extremity arteriogram shows a patent left axillary, brachial, and radial artery as well as interosseous artery. The left ulnar artery is patent proximally but a filling defect is seen above the wrist consistent with thrombus. There is a 2 cm segment of the distal ulnar artery just below the wrist that is occluded. The palmar arch fills from the radial artery. Filling defects are seen in the digital arteries of second through fourth digits with poor flow distal to the third joint of the fourth finger.
Our hospital coder (coding for professional charges) wants to code both non-selective 36221 and selective 36216 for the arch aortogram...they also did an injection of nitriglycerin in the extremity. I'm thinking 36216, 75710, 96373 (??) & 75625? I need to do more Head & Neck!
Please see below report and share your thoughts, thanks!
Procedure: Arch aortogram, selective left upper extremity arteriogram with the catheter in the axillary artery, intra-arterial infusion of radioactive drug.
After full examination of risks and benefits of the procedure informed consent was obtained. Both groins were sterilely prepared and draped. The right common femoral artery was punctured under ultrasound guidance and a 5 French sheath was inserted. A pigtail catheter was advanced into the ascending aorta and an arch aortogram was done. The left subclavian artery was then selected and a Davis catheter advanced into the axillary artery. A left upper extremity arteriogram was done. 100 mcg of nitroglycerin was then injected intra-arterially and repeat angiogram of the hand was performed. Catheters and wires were removed and access site closed using an Angio-Seal device.
Findings: The arch aorta is widely patent with no evidence of atherosclerotic disease in the angiogram. The visualized portions of both common carotid arteries and the right subclavian artery are patent. Flow in both vertebral arteries is antegrade.
Selective left upper extremity arteriogram shows a patent left axillary, brachial, and radial artery as well as interosseous artery. The left ulnar artery is patent proximally but a filling defect is seen above the wrist consistent with thrombus. There is a 2 cm segment of the distal ulnar artery just below the wrist that is occluded. The palmar arch fills from the radial artery. Filling defects are seen in the digital arteries of second through fourth digits with poor flow distal to the third joint of the fourth finger.