dimplez
Contributor
Can someone please assist with this procedure? I have never done these before and am assisting someone who is debating with the dr on coding the separate runoff while he states the code for the total aortogram and extremeities. She is saying since he repositioned the catheter he should be reporting separately....any advice?? Here is the procedure note.
The right groin was locally anesthetized with 1% lidocaine without epinephrine. The right common femoral artery was accessed in a retrograde manner using a 5-French micropuncture set. The patient received 2000 units of intravenous heparin. Over a 0.035 inch guidewire, a 5-French sheath was placed and a 5-French Omni Flush catheter was positioned in the proximal abdominal aorta. An AP aortogram was performed using power injection angiography. Next, the pigtail catheter was positioned above the aortic bifurcation, and an additional view of the distal aorta and bilateral common iliac arteries and proximal femoral vessels was performed using power injection angiography. A 0.035 inch Glidewire and a 5-French Omni Flush catheter was used to selectively catheterize, the left iliac system and under fluoroscopic guidance, the 5 French catheter was advanced to the level of the left common femoral artery. Left lower extremity runoff was then performed in a sequential fashion down to the level of the foot with multiple oblique views at the level of the knee in order to visualize the vessel, given the presence of a prosthetic knee joint. The pigtail catheter was positioned in the right common iliac artery and right lower extremity angiography was performed in a sequential fashion with oblique views performed at the level of the knee. Following this, the catheters, guidewires, and sheaths were removed and pressure was held over the right groin with satisfactory achievement of hemostasis. The patient tolerated the procedure well and was transported to the recovery area for further care and monitoring.
Any assistance and I will be greatly appreciative! Thank you, Marisa
The right groin was locally anesthetized with 1% lidocaine without epinephrine. The right common femoral artery was accessed in a retrograde manner using a 5-French micropuncture set. The patient received 2000 units of intravenous heparin. Over a 0.035 inch guidewire, a 5-French sheath was placed and a 5-French Omni Flush catheter was positioned in the proximal abdominal aorta. An AP aortogram was performed using power injection angiography. Next, the pigtail catheter was positioned above the aortic bifurcation, and an additional view of the distal aorta and bilateral common iliac arteries and proximal femoral vessels was performed using power injection angiography. A 0.035 inch Glidewire and a 5-French Omni Flush catheter was used to selectively catheterize, the left iliac system and under fluoroscopic guidance, the 5 French catheter was advanced to the level of the left common femoral artery. Left lower extremity runoff was then performed in a sequential fashion down to the level of the foot with multiple oblique views at the level of the knee in order to visualize the vessel, given the presence of a prosthetic knee joint. The pigtail catheter was positioned in the right common iliac artery and right lower extremity angiography was performed in a sequential fashion with oblique views performed at the level of the knee. Following this, the catheters, guidewires, and sheaths were removed and pressure was held over the right groin with satisfactory achievement of hemostasis. The patient tolerated the procedure well and was transported to the recovery area for further care and monitoring.
Any assistance and I will be greatly appreciative! Thank you, Marisa