Wiki Balloon angioplasty without stent for coarctation of aorta-HELP CODING

ljones88

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Hi all,

Does anyone know what CPT code to report for a balloon angioplasty without a stent for repair of coarctation of the aorta?

Op report reads:

Initial pressures and saturations were obtained as detailed on the accompanying diagram. Pulmonary artery pressures were 13 mmHg. There was a slight gradient from the single ventricle into the ascending aorta. There was a gradient of 16 mmHg from the ascending aorta to the descending aorta. An angiogram was performed in the transverse arch in the region of pressure change. This demonstrated a region of discrete narrowing slightly distal to the left subclavian artery. The transverse arch proximal to the left subclavian measured 13 mm. The aorta at the diaphragm measured 12 mm. The narrowest region measured 7.5 mm. Balloon angioplasty was initially performed with a Tyshak 12 mm x 3 cm balloon to a maximal pressure of 4 atm. This was slightly above the nominal pressure, and the maximal diameter of the balloon was 13 mm compared to a residual waist in the balloon measuring 11 mm. There was a residual gradient of approximately 10 mmHg. An angiogram
demonstrated no evidence of complication. It was elected to repeat angioplasty with a 12 mm high pressure Z-Med balloon to a maximal pressure of 8 atm. There was no residual waist in the balloon. Repeat pressure measurements showed a residual gradient of only 2 mmHg. A repeat angiogram demonstrated no evidence of complication and an increase in the narrowest region to 10 mm. The jugular venous catheter was then manipulated with slight difficulty into the innominate vein. An angiogram here demonstrated a small collateral from the left side of the innominate vein with runoff posteriorly into paravertebral vessels. This collateral did not appear to enter the pulmonary veins or atrium. It was therefore elected not to occlude this vessel at this time.
 
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