here is the situation--insertion site is rt.fem.artery--a rt.and lt.heart cath.was done first--
The 6 F JR4 catheter was pulled back into
the abdominal aorta and a hand injection of Isovue 370 was performed
to evaluate the common iliac arteries.
Common iliac artery IVUS
Due to evidence of iliac calcification and stenosis on CT, it was decided to further
evaluate the iliac arteries with intravenous ultrasound (IVUS)
imaging. A weight-based bolus dose of unfractionated heparin was
administered to achieve an ACT of >200 sec, and maintained above 200
sec for the duration of the IVUS procedure. The patient received a
total heparin dose of 4,500 units. A 6F JR4 diagnostic catheter was
used to advance the 0.035 J-wire into the left common iliac artery.
The catheter was removed and a 6F IMA guide catheter was advanced into
the left common iliac artery. A 0.014 Prowater Flex coronary
guidewire was advanced into the distal left common iliac artery.
After its position was confirmed by contrast injection, an ultrasound
imaging catheter was passed over the Prowater Flex wire into the
distal vessel. Image recording was initiated and iliac artery
ultrasound images were acquired during 0.5 mm per second pullback.
IVUS evaluation revealed a left common iliac artery with minimal
luminal diameter of 40mm. The IMA guide catheter was pulled back into
the distal right common iliac artery, and the Prowater Flex wire was
advanced to the proximal right common iliac artery. After its
position was confirmed by contrast injection, an ultrasound imaging
catheter was passed over the Prowater Flex wire into the proximal
vessel. Image recording was initiated and iliac artery ultrasound
images were acquired during 0.5 mm per second pullback. IVUS
evaluation revealed a right common iliac artery with minimal luminal
diameter of 40mm.
rt.and lt. cath.w.graft angio-93461
75716
37250
75945
37251
75946
can I bill 36245 for contralat.cath. to lt.comm.iliac if cath.was done for IVUS and not a selective angio or intervention?
Thanks.
The 6 F JR4 catheter was pulled back into
the abdominal aorta and a hand injection of Isovue 370 was performed
to evaluate the common iliac arteries.
Common iliac artery IVUS
Due to evidence of iliac calcification and stenosis on CT, it was decided to further
evaluate the iliac arteries with intravenous ultrasound (IVUS)
imaging. A weight-based bolus dose of unfractionated heparin was
administered to achieve an ACT of >200 sec, and maintained above 200
sec for the duration of the IVUS procedure. The patient received a
total heparin dose of 4,500 units. A 6F JR4 diagnostic catheter was
used to advance the 0.035 J-wire into the left common iliac artery.
The catheter was removed and a 6F IMA guide catheter was advanced into
the left common iliac artery. A 0.014 Prowater Flex coronary
guidewire was advanced into the distal left common iliac artery.
After its position was confirmed by contrast injection, an ultrasound
imaging catheter was passed over the Prowater Flex wire into the
distal vessel. Image recording was initiated and iliac artery
ultrasound images were acquired during 0.5 mm per second pullback.
IVUS evaluation revealed a left common iliac artery with minimal
luminal diameter of 40mm. The IMA guide catheter was pulled back into
the distal right common iliac artery, and the Prowater Flex wire was
advanced to the proximal right common iliac artery. After its
position was confirmed by contrast injection, an ultrasound imaging
catheter was passed over the Prowater Flex wire into the proximal
vessel. Image recording was initiated and iliac artery ultrasound
images were acquired during 0.5 mm per second pullback. IVUS
evaluation revealed a right common iliac artery with minimal luminal
diameter of 40mm.
rt.and lt. cath.w.graft angio-93461
75716
37250
75945
37251
75946
can I bill 36245 for contralat.cath. to lt.comm.iliac if cath.was done for IVUS and not a selective angio or intervention?
Thanks.