margaret fahy
Guru
Hey Guys,
I really need some input here...
Guys,
Can someone help me with this one?
Multiple lower extremity diagnostic angiograms prior to embolization.
Do I code for each angiogram?
They are-36245-SFA; 36246-Popliteal; 36247-Ant.Tibial; and 36247-dorsalis pedis & lateral & medial Tarsals.....
The RS&I's would be: 75710; 75774 X3-or 4?
I know the Embo code is 37204....oh, and the post embo angio-75898.
I need to know how to code for all of the angiographies....do i get just one and then use all of the rs&i's?
Please help me to get this coded so i can use it as a reference.....
Thanks so much.
Margie
1. Access of the right superficial femoral artery under
ultrasound guidance.
2. Selective catheterization of the right superficial femoral
artery and angiogram.
3. Selective catheterization of the right popliteal artery and
angiogram.
4. Selective catheterization of the right anterior tibial artery
and angiogram.
5. Selective catheterization of the right dorsalis pedis artery,
lateral and medial tarsal arteries and angiogram.
6. Ultrasound guided access of the AVM nidus along the dorsal
aspect of the foot and embolization using one mL of glue (50/50)
7. Post embolization angiogram.
8. Unsuccessful access of the AVM nidus between the first and
second metatarsal heads.
9. Hemostasis with manual compression.
PROCEDURE IN DETAILS: The skin of the right groin as well as
right leg and foot was prepped and draped in sterile fashion.
Using US guidance a 21 gauge needle was inserted in the right
superficial femoral artery in antegrade approach. Once arterial
blood return was obtained a .018" Nitrex wire was placed into the
artery and advanced to the distal superficial femoral artery .
The needle was removed and replaced with a 4 French micropuncture
sheath/dilator set. The wire was sized up to a 0.035" Newton
wire, and a 5 French vascular sheath was placed into the artery.
Via the arterial sheath a 5 French JB1 catheter was advanced into
the distal right superficial femoral artery, contrast was
injected and DSA angiogram was obtained. Then the catheter was
advanced into the right popliteal artery, the contrast was
injected and DSA angiogram was obtained. Then the catheter was
advanced into the right anterior tibial artery, the contrast was
injected and DSA angiogram was obtained. The images were reviewed
carefully and compared with the prior study. The decision was
made to do percutaneous embolization of a small AVM nidus along
the dorsal aspect of the foot between the third and fourth
metatarsal bones.
The nidus of the AVM along the dorsal aspect of the foot between
the third and fourth metatarsal bones, adjacent to the skin
graft/ulcer was accessed under ultrasound guidance using a
21-gauge needle. The contrast was injected , which confirmed the
tip of the needle within the nidus of AVM. Embolization was
performed utilizing one mL of glue mixed with Lipidol (50/50).
The glue was injected under fluoroscopic guidance which
demonstrated satisfactory embolization of the nidus without
nontarget embolization. Post embolization angiogram was performed
via JB1 catheter at the anterior tibial artery. This demonstrated
satisfactory decrease of AVM nidus without evidence of nontarget
embolization.
Additional AVM was noted between the first and second metatarsal
bones heads. Multiple attempts were performed to access this
nidus percutaneously with ultrasound guidance, but were
unsuccessful.
Then JB1 catheter was advanced into the right dorsalis pedis
utilizing 035 Newton wire. The contrast was injected and
angiogram was obtained. Then selective catheterization of the
medial and lateral dorsal arteries was performed using JB one1
catheter, contrast was injected and angiogram was obtained.
The catheter and sheath were then removed and hemostasis was
achieved with manual compression for 15 minutes. A sterile
occlusive dressing was applied at the site. There were no
complications associated with the procedure and the patient was
transferred
Margaret Fahy
--------------------------------------------------------------------------------
2nd request-help-how many of these angiographies do i code...?
I really need some input here...
Guys,
Can someone help me with this one?
Multiple lower extremity diagnostic angiograms prior to embolization.
Do I code for each angiogram?
They are-36245-SFA; 36246-Popliteal; 36247-Ant.Tibial; and 36247-dorsalis pedis & lateral & medial Tarsals.....
The RS&I's would be: 75710; 75774 X3-or 4?
I know the Embo code is 37204....oh, and the post embo angio-75898.
I need to know how to code for all of the angiographies....do i get just one and then use all of the rs&i's?
Please help me to get this coded so i can use it as a reference.....
Thanks so much.
Margie
1. Access of the right superficial femoral artery under
ultrasound guidance.
2. Selective catheterization of the right superficial femoral
artery and angiogram.
3. Selective catheterization of the right popliteal artery and
angiogram.
4. Selective catheterization of the right anterior tibial artery
and angiogram.
5. Selective catheterization of the right dorsalis pedis artery,
lateral and medial tarsal arteries and angiogram.
6. Ultrasound guided access of the AVM nidus along the dorsal
aspect of the foot and embolization using one mL of glue (50/50)
7. Post embolization angiogram.
8. Unsuccessful access of the AVM nidus between the first and
second metatarsal heads.
9. Hemostasis with manual compression.
PROCEDURE IN DETAILS: The skin of the right groin as well as
right leg and foot was prepped and draped in sterile fashion.
Using US guidance a 21 gauge needle was inserted in the right
superficial femoral artery in antegrade approach. Once arterial
blood return was obtained a .018" Nitrex wire was placed into the
artery and advanced to the distal superficial femoral artery .
The needle was removed and replaced with a 4 French micropuncture
sheath/dilator set. The wire was sized up to a 0.035" Newton
wire, and a 5 French vascular sheath was placed into the artery.
Via the arterial sheath a 5 French JB1 catheter was advanced into
the distal right superficial femoral artery, contrast was
injected and DSA angiogram was obtained. Then the catheter was
advanced into the right popliteal artery, the contrast was
injected and DSA angiogram was obtained. Then the catheter was
advanced into the right anterior tibial artery, the contrast was
injected and DSA angiogram was obtained. The images were reviewed
carefully and compared with the prior study. The decision was
made to do percutaneous embolization of a small AVM nidus along
the dorsal aspect of the foot between the third and fourth
metatarsal bones.
The nidus of the AVM along the dorsal aspect of the foot between
the third and fourth metatarsal bones, adjacent to the skin
graft/ulcer was accessed under ultrasound guidance using a
21-gauge needle. The contrast was injected , which confirmed the
tip of the needle within the nidus of AVM. Embolization was
performed utilizing one mL of glue mixed with Lipidol (50/50).
The glue was injected under fluoroscopic guidance which
demonstrated satisfactory embolization of the nidus without
nontarget embolization. Post embolization angiogram was performed
via JB1 catheter at the anterior tibial artery. This demonstrated
satisfactory decrease of AVM nidus without evidence of nontarget
embolization.
Additional AVM was noted between the first and second metatarsal
bones heads. Multiple attempts were performed to access this
nidus percutaneously with ultrasound guidance, but were
unsuccessful.
Then JB1 catheter was advanced into the right dorsalis pedis
utilizing 035 Newton wire. The contrast was injected and
angiogram was obtained. Then selective catheterization of the
medial and lateral dorsal arteries was performed using JB one1
catheter, contrast was injected and angiogram was obtained.
The catheter and sheath were then removed and hemostasis was
achieved with manual compression for 15 minutes. A sterile
occlusive dressing was applied at the site. There were no
complications associated with the procedure and the patient was
transferred
Margaret Fahy
--------------------------------------------------------------------------------
2nd request-help-how many of these angiographies do i code...?
