jdibble
True Blue
The physician did the following:
The patient was referred for thrombolysis of the bilateral pulmonary emboli.
Procedure:
1. Right and left common femoral veous access
2. Selective right pulmonary angiogram
3. Selective thrombolysis of the right main and left main pulmonary artery using an EKOS catheter.
Patient was prepped and draped in a sterial fashion after informed consent was obtained. A micropuncutre kit was used to access the right common femoarl vein. A 6-French sheath was advnaced into the right common femoarl vein over a guidewire. Next, a micropuncture kit was used to access the left common femoral vein and 6-French sheath inserted into the left common femoral vein. Next, a glidewire was advanced through a multipurpose catheter and advanced into the left main pulmonary artery. Next, a multipurpose catherter was advanced over the guidewire through the left common femoral sheath and advanced up into the right main pulmonary artery. The multipurpose catheter was removed. An 18cm EKOS cahteter was advanced through the right common femoral venous sheath and positioned in the lower branch of the main right pulmonary artery. Next, a 12cm EKOS cahteter was advanced through the left common femoral venous sheath and positioned in the lower branch of the main left pulmonary artery. Ultrasound core was advanced through both EKOS catheters and secured in place. TPA was infused through both dahteters with ultrasound assistance. The sheaths were taped in place and the patient transferred to the intensive care unit in stable condition. Right pulmonary angiogram revealed large thrombus burden in the distal right main pulmonary artery involving the upper and lower branches.
I have 37211-50, 36014-50. Not sure if these are the correct codes and if there are other codes that I should be adding or using.
Also, the next day the patient was returned to the OR for removal of the catheters - I was using 37214-50.
Any help would be great!!!
The patient was referred for thrombolysis of the bilateral pulmonary emboli.
Procedure:
1. Right and left common femoral veous access
2. Selective right pulmonary angiogram
3. Selective thrombolysis of the right main and left main pulmonary artery using an EKOS catheter.
Patient was prepped and draped in a sterial fashion after informed consent was obtained. A micropuncutre kit was used to access the right common femoarl vein. A 6-French sheath was advnaced into the right common femoarl vein over a guidewire. Next, a micropuncture kit was used to access the left common femoral vein and 6-French sheath inserted into the left common femoral vein. Next, a glidewire was advanced through a multipurpose catheter and advanced into the left main pulmonary artery. Next, a multipurpose catherter was advanced over the guidewire through the left common femoral sheath and advanced up into the right main pulmonary artery. The multipurpose catheter was removed. An 18cm EKOS cahteter was advanced through the right common femoral venous sheath and positioned in the lower branch of the main right pulmonary artery. Next, a 12cm EKOS cahteter was advanced through the left common femoral venous sheath and positioned in the lower branch of the main left pulmonary artery. Ultrasound core was advanced through both EKOS catheters and secured in place. TPA was infused through both dahteters with ultrasound assistance. The sheaths were taped in place and the patient transferred to the intensive care unit in stable condition. Right pulmonary angiogram revealed large thrombus burden in the distal right main pulmonary artery involving the upper and lower branches.
I have 37211-50, 36014-50. Not sure if these are the correct codes and if there are other codes that I should be adding or using.
Also, the next day the patient was returned to the OR for removal of the catheters - I was using 37214-50.
Any help would be great!!!