Deleted cpt 75553 mr/cardio morph with contrast

she803

Networker
Messages
93
Best answers
0
What should the updated codes be based on this report? Thanks.

MR/CARDIO MORPH W CONTRAST

Clinical history is Ebstein's anomaly of the tricuspid valve. Cardiac MRI to assess right ventricular function.

Cardiac gated MR examination of the heart was performed. After a preliminary localizing sequence cine white blood imaging was performed in the axial, long axis and short axis planes using a steady state free precession pulse sequence (FIESTA). Comparison is made with prior study from 3/23/2007.

The patient's atrial septal occlusion device produces low signal artifacts in the atrial septum with dephasing artifacts extending into the atrioventricular region of the right ventricle. As on the prior study, the insertion of the septal leaflet of the tricuspid valve is displaced towards the apex of the right ventricle compared to the septal insertion of the anterior leaflet of the mitral valve. The anterior leaflet of the tricuspid valve is also abnormally long also extending far into the right ventricle. The region of coaptation of the anterior and septal leaflet of the tricuspid valve is displaced towards the apex of the right ventricle resulting in a large atrialized portion of the right ventricle. The findings are consistent with the history of Ebstein's anomaly and are similar in appearance to the prior study.

The right atrium and right ventricle are dilated. There is diffuse hypokinesis of the right ventricle with regions of dyskinesia involving the anterior wall. The interventricular septum is deviated towards the left ventricle encroaching on the left ventricular cavity. There is also paradoxical motion of the interventricular septum.

Post processing was performed to assess ventricular function. The numerical values obtained are of limited accuracy due to difficulty in precisely delineating the boundaries between the right atrium and functioning portion of the right ventricle. Also, the patient had a fluctuating heart rate during the examination producing artifacts on the images. Assessment of functional parameters was performed on the axial images as these were least affected by the aforementioned artifacts. The atrialized portion of the right ventricle was included for delineation of the boundaries of the right ventricle to derive numerical values of RV function. RV EDV = 315 cc, RV ESV = 203 cc, RVSV = 112 cc, RVEF = 36%. Reprocessing of the data from the prior study of 3/23/2007 in a similar fashion shows the following values: RV EDV = 272 cc, RV ESV = 174 cc, RVSV = 98 cc, RVEF = 36%. As compared with the prior study, the right ventricle appears more dilated as the volumes are increased. On the current study the left ventricular ejection fraction measures 69% with a stroke-volume 93 ml.


Impression: Findings consistent with Ebstein's anomaly of the tricuspid valve. There is a large atrialized portion of the right ventricle.

As compared with the prior study of 3/23/2007 the right ventricle appears more dilated. Functional parameters for the right ventricle as described above also show increased right ventricular volume since the prior study.
 

donnajrichmond

True Blue
Messages
518
Location
Alexandria, LA
Best answers
0
What should the updated codes be based on this report? Thanks.

MR/CARDIO MORPH W CONTRAST

Clinical history is Ebstein's anomaly of the tricuspid valve. Cardiac MRI to assess right ventricular function.

Cardiac gated MR examination of the heart was performed. After a preliminary localizing sequence cine white blood imaging was performed in the axial, long axis and short axis planes using a steady state free precession pulse sequence (FIESTA). Comparison is made with prior study from 3/23/2007.

The patient's atrial septal occlusion device produces low signal artifacts in the atrial septum with dephasing artifacts extending into the atrioventricular region of the right ventricle. As on the prior study, the insertion of the septal leaflet of the tricuspid valve is displaced towards the apex of the right ventricle compared to the septal insertion of the anterior leaflet of the mitral valve. The anterior leaflet of the tricuspid valve is also abnormally long also extending far into the right ventricle. The region of coaptation of the anterior and septal leaflet of the tricuspid valve is displaced towards the apex of the right ventricle resulting in a large atrialized portion of the right ventricle. The findings are consistent with the history of Ebstein's anomaly and are similar in appearance to the prior study.

The right atrium and right ventricle are dilated. There is diffuse hypokinesis of the right ventricle with regions of dyskinesia involving the anterior wall. The interventricular septum is deviated towards the left ventricle encroaching on the left ventricular cavity. There is also paradoxical motion of the interventricular septum.

Post processing was performed to assess ventricular function. The numerical values obtained are of limited accuracy due to difficulty in precisely delineating the boundaries between the right atrium and functioning portion of the right ventricle. Also, the patient had a fluctuating heart rate during the examination producing artifacts on the images. Assessment of functional parameters was performed on the axial images as these were least affected by the aforementioned artifacts. The atrialized portion of the right ventricle was included for delineation of the boundaries of the right ventricle to derive numerical values of RV function. RV EDV = 315 cc, RV ESV = 203 cc, RVSV = 112 cc, RVEF = 36%. Reprocessing of the data from the prior study of 3/23/2007 in a similar fashion shows the following values: RV EDV = 272 cc, RV ESV = 174 cc, RVSV = 98 cc, RVEF = 36%. As compared with the prior study, the right ventricle appears more dilated as the volumes are increased. On the current study the left ventricular ejection fraction measures 69% with a stroke-volume 93 ml.


Impression: Findings consistent with Ebstein's anomaly of the tricuspid valve. There is a large atrialized portion of the right ventricle.

As compared with the prior study of 3/23/2007 the right ventricle appears more dilated. Functional parameters for the right ventricle as described above also show increased right ventricular volume since the prior study.
I don't see contrast material or stressing mentioned, so 75557.
 
Top