debcoder2016
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PROCEDURES PERFORMED:
1. Ultrasound guided access of the right common femoral artery.
2. Selective catheterization of the infrarenal abdominal aorta.
3. Abdominal aortogram.
4. Selective catheterization of the left external iliac artery.
5. Left lower extremity arteriogram.
6. Selective catherization of the left anterior tibial artery with angiogram.
7. Puncture site closer with a 6Fr angioseal device.
PROCEDURE: The patient was placed supine on the angiographic table. Sterile preparation of the bilateral groin was performed and sterile drapes placed to expose the access site. Ultrasound guided access was made of the right common femoral artery using an 21-gauge micropuncture set . A 0.35 guide wire was advanced under fluoroscopy and a 5 French sheath was placed.
A 5.0 Fr Omniflush catheter was advanced to the abdominal aorta and aortogram was performed with bilateral pelvic obliques. The combination of a C2 catheter and angled glidewire were used to selectively catheterize the left common femoral artery and a left lower extremity arteriogram was performed. The angled catheter was advanced over a guide wire into the left anterior tibial artery and left anterior tibial arteriogram was performed.
All wires and catheters were then removed and hemostasis was obtained with a 6Fr Angioseal device. The patient tolerated the procedure well. There were no immediate complications. The patient was discharged from our care in stable condition.
FINDINGS: The abdominal aorta demonstrated moderate tortuosity but is otherwise unremarkable. The left common, internal, and external iliac arteries are patent without significant stenosis.
Left lower extremity arteriogram demonstrates the common femoral, profunda femoral, and superficial femoral arteries with mild atherosclerotic changes but without significant stenosis. The popliteal artery is unremarkable. Diminshed flow with delayed filling of the anterior tibial artery was initally noted, however with direct injection it was patent to the level of the ankle. The posterior tibial is dominant and patent across the ankle. The peroneal artery was patent to the level of the ankle joint.
MPRESSION:
1. Mild tortuosity but otherwise unremarkable aortogram.
2. Markedly delayed flow in the left lower extremity likely secondary to cardiac output with mild multifocal atherosclertic changes however no hemodynamically significant stenosis was identified.
HISTORY OF PRESENT ILLNESS:
left lower extremity rest pain, ulceration, and diminished TBIs presents for LLE angiogram.
CAN SOMEONE TELL ME IF THESE ARE THE CORRECT CODES PLEASE? THANK YOU KINDLY.
36247
75625,59
75710
76937
ICD-10
I70.209
L97.909
1. Ultrasound guided access of the right common femoral artery.
2. Selective catheterization of the infrarenal abdominal aorta.
3. Abdominal aortogram.
4. Selective catheterization of the left external iliac artery.
5. Left lower extremity arteriogram.
6. Selective catherization of the left anterior tibial artery with angiogram.
7. Puncture site closer with a 6Fr angioseal device.
PROCEDURE: The patient was placed supine on the angiographic table. Sterile preparation of the bilateral groin was performed and sterile drapes placed to expose the access site. Ultrasound guided access was made of the right common femoral artery using an 21-gauge micropuncture set . A 0.35 guide wire was advanced under fluoroscopy and a 5 French sheath was placed.
A 5.0 Fr Omniflush catheter was advanced to the abdominal aorta and aortogram was performed with bilateral pelvic obliques. The combination of a C2 catheter and angled glidewire were used to selectively catheterize the left common femoral artery and a left lower extremity arteriogram was performed. The angled catheter was advanced over a guide wire into the left anterior tibial artery and left anterior tibial arteriogram was performed.
All wires and catheters were then removed and hemostasis was obtained with a 6Fr Angioseal device. The patient tolerated the procedure well. There were no immediate complications. The patient was discharged from our care in stable condition.
FINDINGS: The abdominal aorta demonstrated moderate tortuosity but is otherwise unremarkable. The left common, internal, and external iliac arteries are patent without significant stenosis.
Left lower extremity arteriogram demonstrates the common femoral, profunda femoral, and superficial femoral arteries with mild atherosclerotic changes but without significant stenosis. The popliteal artery is unremarkable. Diminshed flow with delayed filling of the anterior tibial artery was initally noted, however with direct injection it was patent to the level of the ankle. The posterior tibial is dominant and patent across the ankle. The peroneal artery was patent to the level of the ankle joint.
MPRESSION:
1. Mild tortuosity but otherwise unremarkable aortogram.
2. Markedly delayed flow in the left lower extremity likely secondary to cardiac output with mild multifocal atherosclertic changes however no hemodynamically significant stenosis was identified.
HISTORY OF PRESENT ILLNESS:
left lower extremity rest pain, ulceration, and diminished TBIs presents for LLE angiogram.
CAN SOMEONE TELL ME IF THESE ARE THE CORRECT CODES PLEASE? THANK YOU KINDLY.
36247
75625,59
75710
76937
ICD-10
I70.209
L97.909