Attempted embolization???

hwilcox07

Networker
Messages
54
Location
MOBILE, AL
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0
Any advice on how to code the following? I have one wanting to code attempted embolization with modifier and one wanting to code 36140 only.

PROCEDURE: Attempted aneurysm puncture for direct embolization.

After explaining the procedure, alternatives and risks, consent was given.

The patient was placed in the prone position and the lower back was prepped. Using fluoroscopic guidance and a
maximum sterile barrier, three separate punctures were made into the aneurysm sac. Position was confirmed with
three-dimensional CT-like images.

On each puncture, no blood return was encountered. No evidence of persistent endoleak.

Patient scheduled for CTA but creatinine was too elevated. We will obtain a noncontrast CT to exclude
retroperitoneal hemorrhage.

Impression

Unsuccessful attempted direct puncture embolization due to lack of arterial flow within the aneurysm sac.

Follow-up with ultrasound suggested given the elevated creatinine.

Timeout observed.

Fluoroscopic time 4.6 minutes.

Fluoroscopic images 316.
 

luhre

Networker
Messages
57
Location
Syracuse, NY
Best answers
0
Any advice on how to code the following? I have one wanting to code attempted embolization with modifier and one wanting to code 36140 only.

PROCEDURE: Attempted aneurysm puncture for direct embolization.

After explaining the procedure, alternatives and risks, consent was given.

The patient was placed in the prone position and the lower back was prepped. Using fluoroscopic guidance and a
maximum sterile barrier, three separate punctures were made into the aneurysm sac. Position was confirmed with
three-dimensional CT-like images.

On each puncture, no blood return was encountered. No evidence of persistent endoleak.

Patient scheduled for CTA but creatinine was too elevated. We will obtain a noncontrast CT to exclude
retroperitoneal hemorrhage.

Impression

Unsuccessful attempted direct puncture embolization due to lack of arterial flow within the aneurysm sac.

Follow-up with ultrasound suggested given the elevated creatinine.

Timeout observed.

Fluoroscopic time 4.6 minutes.

Fluoroscopic images 316.
36140 can only be used for an extremity.
 

luhre

Networker
Messages
57
Location
Syracuse, NY
Best answers
0
I would code for the attempted Embolization. With that said, I don't believe either one would be incorrect.
 
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