What do you think?
I was thinking
93458, 36215, 75710?
Honestly im never really sure when to use the 75710 so any help/info on it would be greatly appreciated.
REPORT TITLE: catherization report
PROCEDURES PERFORMED
1. Left heart cathetgerization
2. Selective coronary angiography
3. Left ventriculography
4. Left subclavian/LIMA angiography
CONCIOUS SEDATION TIME: 20 minutes
PERCLOSE: right common femoral artery
PRE AND POSTOP DIAGNOSIS: CAD/angina pectoris
INDICATION FOR PROCEDURE: 72 year old man with history of exertional chest pain since February first noted while he was shoveling snow. Subsequent treadmill test where he exercised for 6 mins was both clinically and electronically abnormal. The patient was subsequently referred for cardiology consultation and cardiac catherization with possible mechanical revascularization.
ACCESS: A 6 french sheat right common femoral artery
CATHERERS USED: A 6 french jr4, angled pigtail catherers
EBL: less than 10 ml
RESULTS:
HEMODYNAMICS: aortic pressure 120/70. Left ventricular systolic pressure 120, left ventricular end diagnostic 15 mmhg. No aortic valve gradient on cathether pullback.
LEFT VENTRICULOGRAPHY: left ventricle is of normal size and demonstrates normal systolic function. Visually est fraction is 50-55%. No significant mitral regurgitation.
SELECTIVE CORONARY ANGIOGRAPHY:
LEFT MAIN: The left main is a moderate caliber vessel notable for eccentric 70% distal stenosis involving origins of the LAD and left circumflex.
LAD: The LAD is a small to moderaye calliber transapical vessel notable for a 50% proximal disease involving the origins of the first septal perforator and first diagonal brancj. First diagonal branch is notable for diffuse 30% proximal disease.
LEFT CIRCUMFLEX: Small caliber non dominant vessel. First obtuse marginal is notable for diffuse 50% proximal disease.
RIGHT CORONARY ARTERY: The RCA is a small moderate caliber dominant vessel, which becomes subtotaled in its mid segment with incomplete distal filling.
The distal arteryfills via left to right collaterals.
LEFT SUBCLAVIAN AND LIMA ANGIOGRAPHY: The left subclavian is widely patent. The LIMA is widely patent, appears tp be suitable conduit for bypass grafting.
SUMMARY AND CONCLUSIONS:
1. Diffuse left main/three vessel coronary artery disease as describes.
2. Normal left ventricular size and systolic function
3. No aortic stenosis on catheter pullback
4. No significant mitral regurgitation
5. Successful perclose right common femoral artery
PLAN: Patient will be referred for coronary artery bypass graft surgery.
I was thinking
93458, 36215, 75710?
Honestly im never really sure when to use the 75710 so any help/info on it would be greatly appreciated.
REPORT TITLE: catherization report
PROCEDURES PERFORMED
1. Left heart cathetgerization
2. Selective coronary angiography
3. Left ventriculography
4. Left subclavian/LIMA angiography
CONCIOUS SEDATION TIME: 20 minutes
PERCLOSE: right common femoral artery
PRE AND POSTOP DIAGNOSIS: CAD/angina pectoris
INDICATION FOR PROCEDURE: 72 year old man with history of exertional chest pain since February first noted while he was shoveling snow. Subsequent treadmill test where he exercised for 6 mins was both clinically and electronically abnormal. The patient was subsequently referred for cardiology consultation and cardiac catherization with possible mechanical revascularization.
ACCESS: A 6 french sheat right common femoral artery
CATHERERS USED: A 6 french jr4, angled pigtail catherers
EBL: less than 10 ml
RESULTS:
HEMODYNAMICS: aortic pressure 120/70. Left ventricular systolic pressure 120, left ventricular end diagnostic 15 mmhg. No aortic valve gradient on cathether pullback.
LEFT VENTRICULOGRAPHY: left ventricle is of normal size and demonstrates normal systolic function. Visually est fraction is 50-55%. No significant mitral regurgitation.
SELECTIVE CORONARY ANGIOGRAPHY:
LEFT MAIN: The left main is a moderate caliber vessel notable for eccentric 70% distal stenosis involving origins of the LAD and left circumflex.
LAD: The LAD is a small to moderaye calliber transapical vessel notable for a 50% proximal disease involving the origins of the first septal perforator and first diagonal brancj. First diagonal branch is notable for diffuse 30% proximal disease.
LEFT CIRCUMFLEX: Small caliber non dominant vessel. First obtuse marginal is notable for diffuse 50% proximal disease.
RIGHT CORONARY ARTERY: The RCA is a small moderate caliber dominant vessel, which becomes subtotaled in its mid segment with incomplete distal filling.
The distal arteryfills via left to right collaterals.
LEFT SUBCLAVIAN AND LIMA ANGIOGRAPHY: The left subclavian is widely patent. The LIMA is widely patent, appears tp be suitable conduit for bypass grafting.
SUMMARY AND CONCLUSIONS:
1. Diffuse left main/three vessel coronary artery disease as describes.
2. Normal left ventricular size and systolic function
3. No aortic stenosis on catheter pullback
4. No significant mitral regurgitation
5. Successful perclose right common femoral artery
PLAN: Patient will be referred for coronary artery bypass graft surgery.