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help needed

decus1956

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Procedure in detail:
Sheath in LCFA, alot of tortuosity and moderate disease in LCIA. Decision to advance wire upt ot Aortic arch. Anticoagulation was performed. Then sheath positioned in descending Aortic arch. The dilator was w/drawn from sheath and cath was used to engage origion of L. subclavian artery. Storq wire advance into distal L subclavian.Then repositioned dilator into sheath to L sublcavian stnosis. Angiography of proximal L subaclavian was performed. Decision made to implant stntacross L subclavian stenosis but proximal to origin of L vertebral artey. Stent was deployed to niminal pressures yielding excellent angio results w/full expansion of L. subclavian lesion. There appeared to be dye retention and hang up in proximal portion of L subclavian. Sheath was withdrawn back into aortic arch. Angiography was performed. Decision was made to implant second stent.It was positioned in proximal subclavian covering new lesion but landing zone was overlapping first stent distally and proximal landing zone was just above the ostium of L subclavian.
Deployed w/excellent results and no complications. Following this, angiography was repeated w/excellend angio results of L subclavian stenosis. However in doing these angiograms doctor noted that LIMA didnt appear to be filling very well. Since pt had just had CABG, he felt that it was essential to obtain image of LIMA. Cath was advanced into origin of LIMA, Selective LIMA angio was performed. This showed LIMA apppeared to be occluded in it midsegment. At that point caths and wires were removed. Final angio shoed excellent result of L. subclavian. Following this, doc gurned attention to R renal artery. A cath was advanced into origin of R renal artery, a wire was advanced into renal pelvis atraumatically. Following this ballon was postioned across segment of fibromuscular dysplasia in mid body fo R renal artery. One balloon inflation was perfomred for one minute to nominal pressures. Angiography was repeated, showed good angiographic results w/resolution of hazy segment inside fibromuscular diseased segment of R artery. Sheath left in place, no complicaitons

Codes 36225, 36215, 75710-26, 35471 and 75966-26? Does this sound correct or what am I not seeing?
 

dpeoples

True Blue
Messages
890
Location
Birmingham, Alabama
Best answers
0
Procedure in detail:
Sheath in LCFA, alot of tortuosity and moderate disease in LCIA. Decision to advance wire upt ot Aortic arch. Anticoagulation was performed. Then sheath positioned in descending Aortic arch. The dilator was w/drawn from sheath and cath was used to engage origion of L. subclavian artery. Storq wire advance into distal L subclavian.Then repositioned dilator into sheath to L sublcavian stnosis. Angiography of proximal L subaclavian was performed. Decision made to implant stntacross L subclavian stenosis but proximal to origin of L vertebral artey. Stent was deployed to niminal pressures yielding excellent angio results w/full expansion of L. subclavian lesion. There appeared to be dye retention and hang up in proximal portion of L subclavian. Sheath was withdrawn back into aortic arch. Angiography was performed. Decision was made to implant second stent.It was positioned in proximal subclavian covering new lesion but landing zone was overlapping first stent distally and proximal landing zone was just above the ostium of L subclavian.
Deployed w/excellent results and no complications. Following this, angiography was repeated w/excellend angio results of L subclavian stenosis. However in doing these angiograms doctor noted that LIMA didnt appear to be filling very well. Since pt had just had CABG, he felt that it was essential to obtain image of LIMA. Cath was advanced into origin of LIMA, Selective LIMA angio was performed. This showed LIMA apppeared to be occluded in it midsegment. At that point caths and wires were removed. Final angio shoed excellent result of L. subclavian. Following this, doc gurned attention to R renal artery. A cath was advanced into origin of R renal artery, a wire was advanced into renal pelvis atraumatically. Following this ballon was postioned across segment of fibromuscular dysplasia in mid body fo R renal artery. One balloon inflation was perfomred for one minute to nominal pressures. Angiography was repeated, showed good angiographic results w/resolution of hazy segment inside fibromuscular diseased segment of R artery. Sheath left in place, no complicaitons

Codes 36225, 36215, 75710-26, 35471 and 75966-26? Does this sound correct or what am I not seeing?
I would code:
37205/75960 for L subclavian stent
36215 for L subclavian catheter placement (interpretation did not include vertebral circulation)
75710-59 for L subclavian angiography
75756-59 for LIMA angiography
35471-75966 for renal angioplasty
36245 for renal arter selection (w/o diagnostic images)

HTH :)
 

decus1956

Guest
Messages
44
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0
You r awesome.....

Thanks so much, Danny...... You are awesome... Would you recommend getting Dr Z's book for interventional coding or what would you recommend to help me learn interventional coding better
 

dpeoples

True Blue
Messages
890
Location
Birmingham, Alabama
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0
:)
Thanks so much, Danny...... You are awesome... Would you recommend getting Dr Z's book for interventional coding or what would you recommend to help me learn interventional coding better
Dr Z products are excellent. I also like Medical Assett Management in Atlanta (products). I know there are others but have no person experience with those (others).

HTH
 
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