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celiac artery angio & stent of sma angio

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58
Best answers
0
Please help me out with this coding!

Need some direction!

Procedure:
1: Aortogram
2: Celiac Artery Angio
3: SMA Selective Angio
4: Successful PTA and stent to Ostial SMA

The patient was prepped according to protocol. Access was obtained from the right femoral artery. A 6-french sheath was advanced over safety guidewire, and a pigtail catheter was advanced. Angiography of the aorta was done with hand injection and digital subtraction imaging, then subsequently we used a LIMA catheter that was used to engage with the celiac, superior mesenteric and the left renal artery, respectively, and selective angiography was performed in different angulations, Then, subsequently we used a LIMA guiding catheter, 55cm length, and to engage with the origin of the superior mesenteric artery, and a 50-mm gradient was noted across the ostial lesion. Then, subseuentlyh we used a 3.5 balloon to predilate the lesion, and due to suboptimal result, decided to proceded with the stent. A 5.0x21 paramount mini GPS stent was deployed at 10 atmospheres and then postdilated into ostial segment in the aorta with an excellent result, abolishing an ostial 90% lesion down to 0, maintaining TIMI 3 flow pre and post. No immediate complications were noted. Angio-seal was deployed in the right femoral artery after confirming mid position with the right femoral artery angiography. The patient will be maintained on Aspirin and Plavix.

Any help will be appreciated!
 

Jim Pawloski

True Blue
Messages
1,244
Location
Ann Arbor
Best answers
0
Please help me out with this coding!

Need some direction!

Procedure:
1: Aortogram
2: Celiac Artery Angio
3: SMA Selective Angio
4: Successful PTA and stent to Ostial SMA

The patient was prepped according to protocol. Access was obtained from the right femoral artery. A 6-french sheath was advanced over safety guidewire, and a pigtail catheter was advanced. Angiography of the aorta was done with hand injection and digital subtraction imaging, then subsequently we used a LIMA catheter that was used to engage with the celiac, superior mesenteric and the left renal artery, respectively, and selective angiography was performed in different angulations, Then, subsequently we used a LIMA guiding catheter, 55cm length, and to engage with the origin of the superior mesenteric artery, and a 50-mm gradient was noted across the ostial lesion. Then, subseuentlyh we used a 3.5 balloon to predilate the lesion, and due to suboptimal result, decided to proceded with the stent. A 5.0x21 paramount mini GPS stent was deployed at 10 atmospheres and then postdilated into ostial segment in the aorta with an excellent result, abolishing an ostial 90% lesion down to 0, maintaining TIMI 3 flow pre and post. No immediate complications were noted. Angio-seal was deployed in the right femoral artery after confirming mid position with the right femoral artery angiography. The patient will be maintained on Aspirin and Plavix.

Any help will be appreciated!
I would code 36245, 36245-59, 75726, 75726-59, 36251, 37236, assuming that findings of the arteriograms are also reported.
HTH,
Jim Pawloski, CIRCC
 

Jim Pawloski

True Blue
Messages
1,244
Location
Ann Arbor
Best answers
0
Jim Thank you! Can you explain how you drew to the at conculsion. I had originally coded 36245 with 75726 and the 37236?
I am assuming that a diagnostic imaging was performed. Since the celiac and SMA were selected and imaged, I used 36245/75726 for the Celiac, and 36245-59 and 75726-59 for the SMA. For the stent, I used 37236. If this was the full dictation that you posted, then I would only code for the stent placement since the diagnostic findings were not reported.

Thanks,
Jim:eek:
 
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