margaret fahy
Guru
Hi, how would you code this? Cannot code for angiographies, as they were done the day before the intervention. I am asking specifically about the catheterizations....LICA and then Left Posterior Communicating Artery. Even if you think it should be the Angiography codes, can you tell me how you would code this strictly as catheterizations?
PROCEDURE: The skin of the right wrist was prepped and draped in
sterile fashion. After local anesthesia, a 21-gauge needle was
inserted into the right radial artery with ultrasound guidance.
Once blood return was obtained a, 0.018" mandril wire was placed
in the artery and advanced under fluoroscopic guidance to the
right radial artery. The needle was removed and a 4 F radial
sheath was placed over the wire into the artery. A radial
cocktail was administered and then the sheath was attached to a
continuous infusion of heparinized saline. A digital subtraction
roadmap was performed with contrast injection which showed a
normal course of the right radial artery. Next a 0.035 inch
Glidewire advantage was used to navigate to the right subclavian
artery using the roadmap. Over the Glidewire advantage the 4
French radial sheath was exchanged for a 6 French Wrist catheter
which was attached to an infusion of heparinized saline. Next the
0.035 inch Glidewire and a 5 French Simmons selective catheter
was advanced and used to select the left common carotid and
subsequently the left internal carotid. The Wrist catheter was
advanced to the internal carotid. Biplane DSA run was performed.
There is redemonstration of a 2.0 cm saccular aneurysm arising
from the left posterior communicating artery. A coaxial 4.2
French Phenom Plus and Phenom 27 catheter and a synchro 2
microwire were used to select the M2 branch of the left MCA. Next
through the Phenom system a 4 mm x 10 mm Pipeline line stent was
landed proximal to the takeoff of M1 and ACA, excluding the
P-comm aneurysm, terminating in the supraclinoid carotid. The
catheter was then removed and a TR band was applied and
insufflated until hemostasis was achieved.
PROCEDURE: The skin of the right wrist was prepped and draped in
sterile fashion. After local anesthesia, a 21-gauge needle was
inserted into the right radial artery with ultrasound guidance.
Once blood return was obtained a, 0.018" mandril wire was placed
in the artery and advanced under fluoroscopic guidance to the
right radial artery. The needle was removed and a 4 F radial
sheath was placed over the wire into the artery. A radial
cocktail was administered and then the sheath was attached to a
continuous infusion of heparinized saline. A digital subtraction
roadmap was performed with contrast injection which showed a
normal course of the right radial artery. Next a 0.035 inch
Glidewire advantage was used to navigate to the right subclavian
artery using the roadmap. Over the Glidewire advantage the 4
French radial sheath was exchanged for a 6 French Wrist catheter
which was attached to an infusion of heparinized saline. Next the
0.035 inch Glidewire and a 5 French Simmons selective catheter
was advanced and used to select the left common carotid and
subsequently the left internal carotid. The Wrist catheter was
advanced to the internal carotid. Biplane DSA run was performed.
There is redemonstration of a 2.0 cm saccular aneurysm arising
from the left posterior communicating artery. A coaxial 4.2
French Phenom Plus and Phenom 27 catheter and a synchro 2
microwire were used to select the M2 branch of the left MCA. Next
through the Phenom system a 4 mm x 10 mm Pipeline line stent was
landed proximal to the takeoff of M1 and ACA, excluding the
P-comm aneurysm, terminating in the supraclinoid carotid. The
catheter was then removed and a TR band was applied and
insufflated until hemostasis was achieved.