chembree
Guru
What CPT code would you use for the below exam?
Limited cardiac CT.
Indication: Mitral valve mass versus calcification.
Technique: Limited CT of the chest was performed without IV contrast
with gating.
Comparison: Prior CT chest xxxx and CTA chest of xxxxx
Findings: Moderate right and small left pleural effusions are present.
Thyromegaly is present. A precarinal lymph node is mildly enlarged
measuring 1.8 x 1.1 cm (image 34). There is aneurysmal dilation of the
descending thoracic aorta which measures up to 4.0 cm, unchanged.
There is also aneurysmal dilation of the aorta at the level of the
hiatus. At this level it measures 3.7 x 5.5 cm compared to 3.6 x 5.2
cm and the prior. Given differences in technique it is not
significantly changed. In the region of the mitral valve is an ovoid
dense calcification measuring 1.4 x 1.8 cm. However evaluation for a
valvular mass is difficult on this noncontrast CT. Paraseptal
emphysema is seen within the lungs. There is bilateral lower lobe
airspace consolidation, right worse than left. There is also
peripheral consolidation within the right middle lobe and lingula left
upper lobe. Cardiomegaly is present. Limited images of the upper
abdomen demonstrate a hepatic cyst. There is also a right renal cyst
which is only partially imaged.
No aggressive osseous lesions.
Impression: Dense ovoid calcification is seen in the region of the
mitral valve which corresponds the findings by echocardiography.
However, soft tissue component is difficult to evaluate given the lack
of IV contrast. This may be better evaluated by cardiac MRI.
Cardiomegaly.
Stable thoracic aortic aneurysm.
Bilateral pleural effusions, right worse than left with bilateral
airspace consolidation as well. This could represent atelectasis
versus pneumonia.
Limited cardiac CT.
Indication: Mitral valve mass versus calcification.
Technique: Limited CT of the chest was performed without IV contrast
with gating.
Comparison: Prior CT chest xxxx and CTA chest of xxxxx
Findings: Moderate right and small left pleural effusions are present.
Thyromegaly is present. A precarinal lymph node is mildly enlarged
measuring 1.8 x 1.1 cm (image 34). There is aneurysmal dilation of the
descending thoracic aorta which measures up to 4.0 cm, unchanged.
There is also aneurysmal dilation of the aorta at the level of the
hiatus. At this level it measures 3.7 x 5.5 cm compared to 3.6 x 5.2
cm and the prior. Given differences in technique it is not
significantly changed. In the region of the mitral valve is an ovoid
dense calcification measuring 1.4 x 1.8 cm. However evaluation for a
valvular mass is difficult on this noncontrast CT. Paraseptal
emphysema is seen within the lungs. There is bilateral lower lobe
airspace consolidation, right worse than left. There is also
peripheral consolidation within the right middle lobe and lingula left
upper lobe. Cardiomegaly is present. Limited images of the upper
abdomen demonstrate a hepatic cyst. There is also a right renal cyst
which is only partially imaged.
No aggressive osseous lesions.
Impression: Dense ovoid calcification is seen in the region of the
mitral valve which corresponds the findings by echocardiography.
However, soft tissue component is difficult to evaluate given the lack
of IV contrast. This may be better evaluated by cardiac MRI.
Cardiomegaly.
Stable thoracic aortic aneurysm.
Bilateral pleural effusions, right worse than left with bilateral
airspace consolidation as well. This could represent atelectasis
versus pneumonia.