Please help with coding this procedure. I am unsure about the femoral angiography section.
Procedure Performed:
1)Left and right femoral artery cannulation and arteriography
2)Right brachial cannulation for catheterization
3)Left and right coronary angiography
Indication for Procedure: Chest pain and possible coronary artery disease
Technique: Right and left femoral arteries with cannulization and angiography. 5 French sheat, 5 French JL 4, JR 4 catheters.
Findings:
1) Hemodynamics: Blood pressure 129/67
2) Femoral angiography: The right femoral artery wasw initially cannulated. The wire could not be advanced. Angiography demonstrated it to be totally occluded in the common femoral. The left common femoral artery was then cannulated, again the wire could not advance. Angiography confirmed a left common femoral total occlusion.
3) Coronary anatomy:
A. The left main coronary artery is calcified with 40% stenosis.
B. The left anterior desceding coronary artery has diffuse calcicication, mild irregularities, no critical disease. The diagonal is small and long with irregularities but no critical disease.
C. The circumflex coronary artery is a moderate size nondominant vessel, calcified, no critical disease. A branching marginal has irregularities but no critical stenosis.
D. The right coronary artery is a dominant vessel. Mildly calcified at the ostium. Mild irregularities, no critical disease. The posterior descending coronary artery and posterolateral branches are small with small posterior left ventricular branch which has no critical disease.
Conclusion:
1) Non-hemodynamically significant coronary artery disease.
2) Normal resting blood pressure.
3) Severe peripheral vascual disease with bilateral common femoral occlusion.
Thanks for any help with this.
Procedure Performed:
1)Left and right femoral artery cannulation and arteriography
2)Right brachial cannulation for catheterization
3)Left and right coronary angiography
Indication for Procedure: Chest pain and possible coronary artery disease
Technique: Right and left femoral arteries with cannulization and angiography. 5 French sheat, 5 French JL 4, JR 4 catheters.
Findings:
1) Hemodynamics: Blood pressure 129/67
2) Femoral angiography: The right femoral artery wasw initially cannulated. The wire could not be advanced. Angiography demonstrated it to be totally occluded in the common femoral. The left common femoral artery was then cannulated, again the wire could not advance. Angiography confirmed a left common femoral total occlusion.
3) Coronary anatomy:
A. The left main coronary artery is calcified with 40% stenosis.
B. The left anterior desceding coronary artery has diffuse calcicication, mild irregularities, no critical disease. The diagonal is small and long with irregularities but no critical disease.
C. The circumflex coronary artery is a moderate size nondominant vessel, calcified, no critical disease. A branching marginal has irregularities but no critical stenosis.
D. The right coronary artery is a dominant vessel. Mildly calcified at the ostium. Mild irregularities, no critical disease. The posterior descending coronary artery and posterolateral branches are small with small posterior left ventricular branch which has no critical disease.
Conclusion:
1) Non-hemodynamically significant coronary artery disease.
2) Normal resting blood pressure.
3) Severe peripheral vascual disease with bilateral common femoral occlusion.
Thanks for any help with this.
