ltassin
New
Hi All,
We currently don't have a coder that knows interventional/special procedures. I'm trying to learn interventional coding on my own and would GREATLY appreciate any help with coding the following procedure. Thanks in advance!!
[FONT="]Procedures performed:[/FONT]
[FONT="]Ultrasound guided venous access.[/FONT]
[FONT="]Left renal vein selection and venogram[/FONT]
[FONT="]Left renal vein pressure measurement[/FONT]
[FONT="]Inferior vena cava pressure measurement[/FONT]
[FONT="]Left renal vein stent placement[/FONT]
[FONT="]
Left renal vein venoplasty
Left renal vein post stenting and venoplasty venogram
Left renal vein post stent and venoplasty pressure measurements
Technique/findings:
Utilizing ultrasound guidance access was obtained to the right femoral
vein with a micropuncture set. A static image was obtained. Access was
upsized to a 6 French sheath over a Bentson wire utilizing standard
technique.
Utilizing a 5 French Cobra catheter and Glidewire the left renal vein
was selected. Venogram demonstrated stenosis at the origin of the left
renal vein and stasis.
Pressure measurements were obtained which demonstrated hemodynamically
significant gradient between the inferior vena cava and left renal
vein.
The sheath at the groin site was exchanged for a long Ansel sheath
utilizing standard technique and renal vein reselected with the Cobra
catheter.
Findings venogram of the left renal vein through the Cobra catheter
and IVC through the long sheath was obtained demonstrating
approximately 3 cm stenosis.
The microcatheter was exchanged for a Rosen wire which was secured
into the distal left renal vein.
A stent was placed across the stenosis of the left renal vein without
complication. Post stent venogram demonstrated well placed stent.
Venoplasty was performed throughout the entirety of the stent without
complication.
Post venoplasty venogram demonstrated improved flow throughout the
left renal vein.
Pressure measurements were obtained and normalized poststent
placement.
The catheter and wire were removed without complication and pressure
was held to achieve hemostasis.
All wire and catheter manipulations were performed under fluoroscopic
guidance. The patient tolerated the procedure well. There were no
immediate complications.[/FONT]
We currently don't have a coder that knows interventional/special procedures. I'm trying to learn interventional coding on my own and would GREATLY appreciate any help with coding the following procedure. Thanks in advance!!
[FONT="]Procedures performed:[/FONT]
[FONT="]Ultrasound guided venous access.[/FONT]
[FONT="]Left renal vein selection and venogram[/FONT]
[FONT="]Left renal vein pressure measurement[/FONT]
[FONT="]Inferior vena cava pressure measurement[/FONT]
[FONT="]Left renal vein stent placement[/FONT]
[FONT="]
Left renal vein venoplasty
Left renal vein post stenting and venoplasty venogram
Left renal vein post stent and venoplasty pressure measurements
Technique/findings:
Utilizing ultrasound guidance access was obtained to the right femoral
vein with a micropuncture set. A static image was obtained. Access was
upsized to a 6 French sheath over a Bentson wire utilizing standard
technique.
Utilizing a 5 French Cobra catheter and Glidewire the left renal vein
was selected. Venogram demonstrated stenosis at the origin of the left
renal vein and stasis.
Pressure measurements were obtained which demonstrated hemodynamically
significant gradient between the inferior vena cava and left renal
vein.
The sheath at the groin site was exchanged for a long Ansel sheath
utilizing standard technique and renal vein reselected with the Cobra
catheter.
Findings venogram of the left renal vein through the Cobra catheter
and IVC through the long sheath was obtained demonstrating
approximately 3 cm stenosis.
The microcatheter was exchanged for a Rosen wire which was secured
into the distal left renal vein.
A stent was placed across the stenosis of the left renal vein without
complication. Post stent venogram demonstrated well placed stent.
Venoplasty was performed throughout the entirety of the stent without
complication.
Post venoplasty venogram demonstrated improved flow throughout the
left renal vein.
Pressure measurements were obtained and normalized poststent
placement.
The catheter and wire were removed without complication and pressure
was held to achieve hemostasis.
All wire and catheter manipulations were performed under fluoroscopic
guidance. The patient tolerated the procedure well. There were no
immediate complications.[/FONT]