Coronary Angio - The left commong femoral

amym

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Bill 93454 only?

The left commong femoral arter has mild to moderate diffuse plaque. The external iliac artery has narrow 40-50% stenosis in only the visualized portion. The patients superficial femoral artery appeal calcified and also has a 60% stenosis.
Left Main: Moderate-sized vessel with mild to moderate luminal irregularities.
Left anterior descending artery: Moderate-sized vessel. Previously placed proximal and mid stents have moderate, diffuse in-stent restenosis. There is an 80% stenosis at the level of diagonal 1. Diagonal 1 has a 60% ostial stenosis, which is consistent with previous cardiac catherization history of being jailed during pecutaneous intervention. Following the diagonal 1, there is 60-70% stenosis. The remainder of the LAD has moderate, diffuse atherosclerosis.
Left circumflex artery: The left circumflex artery has servere disease. There is a 90% proximal stenosis. There is a 99% stenosis in a previously placed stent. Following this 99% in-stent restenosis, there is evidence of distal flow into the remainder of the left circumflex. Previous images show a large-sized distal vessel to the stenosis with 3-4 obtuse marginal branches. There is a mid vessel OM1 branch that is totally occluded.
The right coronary artery is a small sized vessel. There is a 50% mid LV branch stenosis. The remainder of the vessel has mild to moderate luminal irregularities. It give off a small PDA.
LV-Gram: No significant gradient across the aortic valve. No significant elevated LVEDP, equal 15. Due to equipment malfunction, an LV-Gram was not performed. The patient did receive an echo during the hospitalization, which revealed an ejection fraction of 45-50% moderate inferior wall hypokinesis, negative bubble study.
 

Jess1125

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Messages
403
Location
Green Bay
Best answers
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Bill 93454 only?

The left commong femoral arter has mild to moderate diffuse plaque. The external iliac artery has narrow 40-50% stenosis in only the visualized portion. The patients superficial femoral artery appeal calcified and also has a 60% stenosis.
Left Main: Moderate-sized vessel with mild to moderate luminal irregularities.
Left anterior descending artery: Moderate-sized vessel. Previously placed proximal and mid stents have moderate, diffuse in-stent restenosis. There is an 80% stenosis at the level of diagonal 1. Diagonal 1 has a 60% ostial stenosis, which is consistent with previous cardiac catherization history of being jailed during pecutaneous intervention. Following the diagonal 1, there is 60-70% stenosis. The remainder of the LAD has moderate, diffuse atherosclerosis.
Left circumflex artery: The left circumflex artery has servere disease. There is a 90% proximal stenosis. There is a 99% stenosis in a previously placed stent. Following this 99% in-stent restenosis, there is evidence of distal flow into the remainder of the left circumflex. Previous images show a large-sized distal vessel to the stenosis with 3-4 obtuse marginal branches. There is a mid vessel OM1 branch that is totally occluded.
The right coronary artery is a small sized vessel. There is a 50% mid LV branch stenosis. The remainder of the vessel has mild to moderate luminal irregularities. It give off a small PDA.
LV-Gram: No significant gradient across the aortic valve. No significant elevated LVEDP, equal 15. Due to equipment malfunction, an LV-Gram was not performed. The patient did receive an echo during the hospitalization, which revealed an ejection fraction of 45-50% moderate inferior wall hypokinesis, negative bubble study.
You have a 93458 here. Provider appears to have crossed the aortic valve. You don't need to have the LV gram done to bill a 93458 as the LV gram is "when performed".

Jessica CPC, CCC
 
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