JessicaSlone
New
Can someone help clarify something for me?
I've confused myself on if a TCAR is Intrathoracic or Cervical. Below is the operative note. I've coded it as 37215 but I'm wondering if this is a situation where it would need to be the 37217
"In the right neck an incision was made 1 fingerbreadth above the clavicle between the heads of the sternocleidomastoid muscle. Platysma muscle was transected. Appropriate avascular plane was entered between the sternocleidomastoid heads and the internal jugular vein was mobilized laterally. Vagus nerve was identified and kept out of harm's way. Common carotid artery was dissected free from surrounding tissue and encircled with a red vessel loop. 5-0 Prolene diamond suture was placed. Patient had been systemically heparinized with 8000 units. Enroute needle was placed in the middle of the diamond suture followed by placement of the wire. Micropuncture sheath was put in position and arteriogram was performed. Wire was utilized to select the external carotid artery and the micropuncture sheath was placed into the external carotid artery followed by wire. Enroute sheath was placed and then secured in position. Flow reversal system was connected and ensured to be functional. Common carotid artery was clamped after performing TCAR timeout and flow reversal was confirmed. Lesion was crossed and then predilated with a 5 x 20 viatrac balloon. 8 x 30 en route stent was placed across the lesion and deployed. Postplacement dilation was performed with a 5 x 20 balloon. 2-minute washout was performed. Completion images demonstrated excellent technical result without any residual stenosis. Clamp was removed. Flow reversal time of 11 minutes. Total contrast 15 cc. Flow reversal system was removed from the arterial side and allowed to return the blood to the venous side. Arterial sheath was removed and arteriotomy was closed with the previously placed diamond stitch. Excellent hemostasis was assured."
I've confused myself on if a TCAR is Intrathoracic or Cervical. Below is the operative note. I've coded it as 37215 but I'm wondering if this is a situation where it would need to be the 37217
"In the right neck an incision was made 1 fingerbreadth above the clavicle between the heads of the sternocleidomastoid muscle. Platysma muscle was transected. Appropriate avascular plane was entered between the sternocleidomastoid heads and the internal jugular vein was mobilized laterally. Vagus nerve was identified and kept out of harm's way. Common carotid artery was dissected free from surrounding tissue and encircled with a red vessel loop. 5-0 Prolene diamond suture was placed. Patient had been systemically heparinized with 8000 units. Enroute needle was placed in the middle of the diamond suture followed by placement of the wire. Micropuncture sheath was put in position and arteriogram was performed. Wire was utilized to select the external carotid artery and the micropuncture sheath was placed into the external carotid artery followed by wire. Enroute sheath was placed and then secured in position. Flow reversal system was connected and ensured to be functional. Common carotid artery was clamped after performing TCAR timeout and flow reversal was confirmed. Lesion was crossed and then predilated with a 5 x 20 viatrac balloon. 8 x 30 en route stent was placed across the lesion and deployed. Postplacement dilation was performed with a 5 x 20 balloon. 2-minute washout was performed. Completion images demonstrated excellent technical result without any residual stenosis. Clamp was removed. Flow reversal time of 11 minutes. Total contrast 15 cc. Flow reversal system was removed from the arterial side and allowed to return the blood to the venous side. Arterial sheath was removed and arteriotomy was closed with the previously placed diamond stitch. Excellent hemostasis was assured."