Hello.
My provider started performing co-surgeon cases with the IV radiologist. My provider did cutdown of the right axillary and assisted with the lithotripsy balloon angioplasty of the brachiocephalic artery. Is there a specific code for this?
The patient was brought to the hybrid catheterization laboratory and under general endotracheal anesthesia, the areas were prepped and draped in a sterile fashion. Please refer to Dr. ABC's note for his portion of the procedure. I was present for the entire case as was he. Dr. ABC performed a diagnostic arch aortogram through the right femoral artery which identified the innominate artery stenosis and reversal of flow in the carotid vertebral system on the right. I then made a right subclavicular incision and identified the axillary artery in the deltopectoral groove. This was isolated and heparinization was carried out by anesthesiologist and a sheath placed with radiographic guidance. The innominate artery was isolated with wire access and the carotid protection device was then placed by Dr. ABC. The lithotripsy balloon was then introduced with angiographic guidance and the balloon inflated to 6 atmospheres with lithotripsy delivered for 3 shockwave cycles. The balloon was then withdrawn as was the carotid embolic protection device. Completion aortogram revealed widely patent innominate artery with no reversal of flow. The sheath was then removed from the axillary artery and the artery repaired with 5-0 Prolene suture. Doppler was initially used to check flow through the axillary artery and was documented to be excellent. The wound was then closed with layers of Vicryl suture. The skin was closed in usual fashion. The patient tolerated the procedure well.
I'm so lost on this, Any help is greatly appreciated.
My provider started performing co-surgeon cases with the IV radiologist. My provider did cutdown of the right axillary and assisted with the lithotripsy balloon angioplasty of the brachiocephalic artery. Is there a specific code for this?
The patient was brought to the hybrid catheterization laboratory and under general endotracheal anesthesia, the areas were prepped and draped in a sterile fashion. Please refer to Dr. ABC's note for his portion of the procedure. I was present for the entire case as was he. Dr. ABC performed a diagnostic arch aortogram through the right femoral artery which identified the innominate artery stenosis and reversal of flow in the carotid vertebral system on the right. I then made a right subclavicular incision and identified the axillary artery in the deltopectoral groove. This was isolated and heparinization was carried out by anesthesiologist and a sheath placed with radiographic guidance. The innominate artery was isolated with wire access and the carotid protection device was then placed by Dr. ABC. The lithotripsy balloon was then introduced with angiographic guidance and the balloon inflated to 6 atmospheres with lithotripsy delivered for 3 shockwave cycles. The balloon was then withdrawn as was the carotid embolic protection device. Completion aortogram revealed widely patent innominate artery with no reversal of flow. The sheath was then removed from the axillary artery and the artery repaired with 5-0 Prolene suture. Doppler was initially used to check flow through the axillary artery and was documented to be excellent. The wound was then closed with layers of Vicryl suture. The skin was closed in usual fashion. The patient tolerated the procedure well.
I'm so lost on this, Any help is greatly appreciated.