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INDICATIONS: Valvular heart disease, critical aortic stenosis and preop evaluation for TAVR.
.
HISTORY OF PRESENT ILLNESS: The patient is a 79-year-old with critical aortic stenosis, paroxysmal atrial fibrillation, history of DVT and history of subdural hematoma, who presents for evaluation prior to potential transaortic valve replacement. She is referred for angiography to identify her coronary anatomy as well as to identify the patency of her iliofemoral system and therefore an iliofemoral angiogram was performed.
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DETAILS OF PROCEDURE: Informed consent was obtained. The patient understood the risks, benefits and alternatives of the procedure and agreed to proceed with the procedure. The patient in cardiac catheterization laboratory. The right wrist was prepped in a sterile fashion and 2% lidocaine infused subcutaneously until adequate anesthesia was obtained. Right radial artery accessed using modified Seldinger technique. A 6-French 250-mm Glidesheath was placed without complication. Diagnostic 6-French Jacky catheter as well as a pigtail catheter was used to for selective coronary angiography as well as iliofemoral aortography. At the conclusion of the procedure and vascular compression device was used for arterial hemostasis.
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FINDINGS:
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CORONARY ANGIOGRAPHY:
LEFT MAIN: Normal.
LEFT ANTERIOR DESCENDING ARTERY: Normal. First and second diagonals were normal. LEFT CIRCUMFLEX: Normal. First and second marginals were normal. RCA: The right coronary artery was a dominant vessel with prominent PL and PDA system without obstructive disease. There was extensive calcification seen in the aortic root, especially at the sinuses of Valsalva. Distal aorta angiogram and the iliofemoral aortography demonstrated patent aorta without calcification or stenosis. Both common iliacs, internal and external iliacs as well as the common femoral arteries were patent without stenosis or calcification.
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SUMMARY: Normal coronary arteries and normal iliofemoral angiogram.
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CLINICAL PATHWAY: The patient will be referred for evaluation by the TAVR team to determine her candidacy for transaortic valve replacement.

Ok I know this is really simple but I can picture it, please help
I have
93454
75710 is there anything else why or why not Thanks Nancy
 

Jim Pawloski

True Blue
Messages
1,391
Location
Ann Arbor
Best answers
1
INDICATIONS: Valvular heart disease, critical aortic stenosis and preop evaluation for TAVR.
.
HISTORY OF PRESENT ILLNESS: The patient is a 79-year-old with critical aortic stenosis, paroxysmal atrial fibrillation, history of DVT and history of subdural hematoma, who presents for evaluation prior to potential transaortic valve replacement. She is referred for angiography to identify her coronary anatomy as well as to identify the patency of her iliofemoral system and therefore an iliofemoral angiogram was performed.
.
DETAILS OF PROCEDURE: Informed consent was obtained. The patient understood the risks, benefits and alternatives of the procedure and agreed to proceed with the procedure. The patient in cardiac catheterization laboratory. The right wrist was prepped in a sterile fashion and 2% lidocaine infused subcutaneously until adequate anesthesia was obtained. Right radial artery accessed using modified Seldinger technique. A 6-French 250-mm Glidesheath was placed without complication. Diagnostic 6-French Jacky catheter as well as a pigtail catheter was used to for selective coronary angiography as well as iliofemoral aortography. At the conclusion of the procedure and vascular compression device was used for arterial hemostasis.
.
FINDINGS:
.
CORONARY ANGIOGRAPHY:
LEFT MAIN: Normal.
LEFT ANTERIOR DESCENDING ARTERY: Normal. First and second diagonals were normal. LEFT CIRCUMFLEX: Normal. First and second marginals were normal. RCA: The right coronary artery was a dominant vessel with prominent PL and PDA system without obstructive disease. There was extensive calcification seen in the aortic root, especially at the sinuses of Valsalva. Distal aorta angiogram and the iliofemoral aortography demonstrated patent aorta without calcification or stenosis. Both common iliacs, internal and external iliacs as well as the common femoral arteries were patent without stenosis or calcification.
.
SUMMARY: Normal coronary arteries and normal iliofemoral angiogram.
.
CLINICAL PATHWAY: The patient will be referred for evaluation by the TAVR team to determine her candidacy for transaortic valve replacement.

Ok I know this is really simple but I can picture it, please help
I have
93454
75710 is there anything else why or why not Thanks Nancy


Hi Nancy,
Besides the coronary angio, I would bill G0278 because only the pelvis was imaged during the heart cath. Not enough information for 75710.
HTH,
Jim Pawloski, CIRCC
 
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