amym
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Is it appropriate to bill 93458-26-59, 36200, 75630-26 or not enough information?
PROCEDURES PERFORMED:
Left heart catheterization with ventriculography.
• Abdominal Aortogram with Bilateral Runoffs.
• Abdominal aortography.
INDICATIONS: Angina/MI: angina. Lower extremity: claudication.
SUMMARY
• Coronary circulation:
• There was 2-vessel coronary artery disease (LAD and RCA).
• Proximal RCA: There was a 100 % stenosis.
• Cardiac structures:
• Global left ventricular function was normal. EF calculated by contrast ventriculography was 60 %.
• Right lower extremity vessels:
• Right common iliac: There was a 100 % stenosis at the site of a prior stent. Reconnects at the common femoral
artery.
• Right posterior tibial: There was a 100 % stenosis. There was two vessel runoff.
RECOMMENDATIONS:
• Patient management should include medical treatment.
• Peripheral surgical revascularization. Will need Fem-Fem bypass.
Ventricles: There were no left ventricular global or regional wall motion abnormalities. Global left ventricular function was
normal. EF calculated by contrast ventriculography was 60 %.
Coronary circulation: The coronary circulation is right dominant. There was 2-vessel coronary artery disease (LAD and
RCA). Proximal LAD: There was a 50 % stenosis just after D1. Proximal RCA: There was a 100 % stenosis. Distal RCA:
The artery was supplied by heavy collaterals from the left.
Aorta: Abdominal aorta: The segment was normal in size. There was heavy atherosclerosis.
Abdominal vessels: Left renal: Normal. Right renal: Normal.
Left lower extremity vessels: Left common iliac: There was a 40 % stenosis at the site of a prior stent. There was three
vessel runoff.
Right lower extremity vessels: Right common iliac: There was a 100 % stenosis at the site of a prior stent. Reconnects
at the common femoral artery. Right posterior tibial: There was a 100 % stenosis. There was two vessel runoff.
Procedure:
1. Left femoral artery access. The puncture site was infiltrated with local anesthetic. The vessel was accessed using
the modified Seldinger technique.
2. Abdominal Aortogram with Bilateral Runoffs.
3. Abdominal aortography. A catheter was placed and contrast was injected.
Complications:
1. No complications occurred during the cath lab visit.
PROCEDURES PERFORMED:
Left heart catheterization with ventriculography.
• Abdominal Aortogram with Bilateral Runoffs.
• Abdominal aortography.
INDICATIONS: Angina/MI: angina. Lower extremity: claudication.
SUMMARY
• Coronary circulation:
• There was 2-vessel coronary artery disease (LAD and RCA).
• Proximal RCA: There was a 100 % stenosis.
• Cardiac structures:
• Global left ventricular function was normal. EF calculated by contrast ventriculography was 60 %.
• Right lower extremity vessels:
• Right common iliac: There was a 100 % stenosis at the site of a prior stent. Reconnects at the common femoral
artery.
• Right posterior tibial: There was a 100 % stenosis. There was two vessel runoff.
RECOMMENDATIONS:
• Patient management should include medical treatment.
• Peripheral surgical revascularization. Will need Fem-Fem bypass.
Ventricles: There were no left ventricular global or regional wall motion abnormalities. Global left ventricular function was
normal. EF calculated by contrast ventriculography was 60 %.
Coronary circulation: The coronary circulation is right dominant. There was 2-vessel coronary artery disease (LAD and
RCA). Proximal LAD: There was a 50 % stenosis just after D1. Proximal RCA: There was a 100 % stenosis. Distal RCA:
The artery was supplied by heavy collaterals from the left.
Aorta: Abdominal aorta: The segment was normal in size. There was heavy atherosclerosis.
Abdominal vessels: Left renal: Normal. Right renal: Normal.
Left lower extremity vessels: Left common iliac: There was a 40 % stenosis at the site of a prior stent. There was three
vessel runoff.
Right lower extremity vessels: Right common iliac: There was a 100 % stenosis at the site of a prior stent. Reconnects
at the common femoral artery. Right posterior tibial: There was a 100 % stenosis. There was two vessel runoff.
Procedure:
1. Left femoral artery access. The puncture site was infiltrated with local anesthetic. The vessel was accessed using
the modified Seldinger technique.
2. Abdominal Aortogram with Bilateral Runoffs.
3. Abdominal aortography. A catheter was placed and contrast was injected.
Complications:
1. No complications occurred during the cath lab visit.
