Procedure performed:
RHC
Pulmonary Thrombectomy utilizing the lightning 12 system - Left PA and Right PA
IVC Filter placement with a Cook 30 device
Coronary angiography with interpretation
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Pre Proc Diagnosis: Sub Massive PE, residual DVT, new severe cardiomyopathy, NSTEMI
1st paragraph addressed the right heart cath and coronary angiography
2nd paragraph:
We then used a JR4 diagnostic catheter and a J-wire to advance in the venous sheath into the left pulmonary artery. An Amplatz extra-wire was then placed in the sheath was sized up to a 14 French 65 cm Gore dry sheath. The lightning 12 penumbra catheter was then advanced over this wire into the left PA and multiple passes were obtained with significant clot removed. Using the same technique we redirected ourselves into the right PA and repeated the same maneuvers. A right heart catheterization was performed with a pigtail cath followed by selective anigography in the right and left PA. These wires and catheters were then removed from the body.
A short 12 French Cook sheath was then replaced in the venous access. A Cook 30 mm IVC filter was then deployed in standard fashion just below the intake of the renal arteries.
My codes: 93456, 37191 (IVC filter), 37184-50 (thrombectomy right and left PA) - lightning 12 system appears to be Penumbra so can this be coded being it's not mechanical?, 75743 (angiography bilateral pulmonary)
Thank you for all of the knowledgeable opinions on this site.
RHC
Pulmonary Thrombectomy utilizing the lightning 12 system - Left PA and Right PA
IVC Filter placement with a Cook 30 device
Coronary angiography with interpretation
---------------------------------------------------------------------------------------------------------------------------------------
Pre Proc Diagnosis: Sub Massive PE, residual DVT, new severe cardiomyopathy, NSTEMI
1st paragraph addressed the right heart cath and coronary angiography
2nd paragraph:
We then used a JR4 diagnostic catheter and a J-wire to advance in the venous sheath into the left pulmonary artery. An Amplatz extra-wire was then placed in the sheath was sized up to a 14 French 65 cm Gore dry sheath. The lightning 12 penumbra catheter was then advanced over this wire into the left PA and multiple passes were obtained with significant clot removed. Using the same technique we redirected ourselves into the right PA and repeated the same maneuvers. A right heart catheterization was performed with a pigtail cath followed by selective anigography in the right and left PA. These wires and catheters were then removed from the body.
A short 12 French Cook sheath was then replaced in the venous access. A Cook 30 mm IVC filter was then deployed in standard fashion just below the intake of the renal arteries.
My codes: 93456, 37191 (IVC filter), 37184-50 (thrombectomy right and left PA) - lightning 12 system appears to be Penumbra so can this be coded being it's not mechanical?, 75743 (angiography bilateral pulmonary)
Thank you for all of the knowledgeable opinions on this site.