Wiki Lower IR Help

Lynda Wetter

True Blue
Local Chapter Officer
Messages
515
Location
Glen Allen, VA
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The codes I feel are right are in BOLD- Please bear with the formatting it did not copy and paste well. I did try to fix it a bit.

Procedure Report Summary
Summary: I do not code from here rather just glance and take note of what they are saying.
Access:
Left common femoral. Guidance: ultrasound with permanent recording and reporting.
Closure type: Angioseal
Right
abdominal aorta selective abdominal aortagram
Right proximal common femoral selective right lower extremity peripheral angiogram
Right tibioperoneal trunk
Right mid superficial femoral artery: atherectomy.
Right mid superficial femoral artery: IVUS.
Right mid superficial femoral artery: stent.
Right mid superficial femoral artery: suction thrombectomy.
Right mid superficial femoral artery: plain balloon.
Right distal superficial femoral artery: IVUS.
Right distal superficial femoral artery: stent.
Right distal superficial femoral artery: atherectomy.
Right distal superficial femoral artery: plain balloon.
Right proximal popliteal: atherectomy.
Right proximal popliteal: plain balloon.
Right proximal popliteal: IVUS.
Right tibioperoneal trunk: suction thrombectomy.
Right tibioperoneal trunk, Right popliteal, Right superficial femoral artery and Right common femoral: IVUS.

Contrast type: Isovue 105 ml.
Total fluoro time: 16.16 min:sec
Cumulative air kerma: 68.99 mGy
Dose area product: 20.9 Gycm2
Total sedation: 65.6 min

Procedures performed:
Lower extremity angiogram with intervention

Vascular access:
Left common femoral.
5 sheath 10 cm sheath 5f stiff access kit, 7f 45cm Destination sheath
ultrasound with permanent recording and reporting, needle: 20 gauge, device: 5f stiff access kit 76937
Disposition: closure device successful: Angioseal and 6f Angio Seal
Removed in lab: catheters, wires, and sheaths

Catheter/imaging:
Peripheral Diagnostic
5F 65CM OMNI FLUSH
Abdominal aorta: selective abdominal aortagram 75625-59
5F 65CM OMNI FLUSH
Right proximal common femoral: selective right lower extremity peripheral angiogram- 36246This would not be coded
C
XC .035 90cm support catheter
Right tibioperoneal trunk:

Diagnostic findings: DX code pulled here
Peripheral angiographic findings
Abdominal aorta:
Right common iliac:
Right external iliac:
Right common femoral: 50 59%
stenosis.
Right mid superficial femoral artery: 90 99%
stenosis.
Right distal superficial femoral artery: 70 79%
stenosis.
Right proximal popliteal: 90 99%
stenosis.
Right tibioperoneal trunk:
Left common iliac:
Left external iliac:

Interventions:
Peripheral interventions

Right mid superficial femoral artery Atherectomy,
7f HawkOne LS

Right distal superficial femoral artery Atherectomy,
7f HawkOne LS :, max burr size: 0 mm, max laser fluency: 0 mJ/mm2

Right proximal popliteal Atherectomy,
7f HawkOne LS

Right tibioperoneal trunk , Right popliteal , Right superficial femoral artery , Right common femoral
IVUS -37252 how many 37253’s? Each vessel, so x3?
.014 VOLCANO IVUS CATHETER:

Right mid superficial femoral artery
Plain Balloon max inflation pressure: 8 atm for 60 sec
Right distal superficial femoral artery Plain Balloon max inflation pressure: 8 atm for 60 sec
Right proximal popliteal Plain Balloon max inflation pressure: 8 atm for 60 sec

Right proximal popliteal
IVUS
.014 VOLCANO IVUS CATHETER
Right distal superficial femoral artery
IVUS
.014 VOLCANO IVUS CATHETER
Right mid superficial femoral artery
IVUS
.014 VOLCANO IVUS CATHETER

Right distal superficial femoral artery Stent
6x60mm Protege EverFlex and exp:08/02/2021 lot#A686701
Right mid superficial femoral artery Stent------37227 to include all interventions in the Fem-pop area PTA, stent & Athrectomy
6x80mm Protege EverFlex and lot#A656606 exp:06/05/2021
Right tibioperoneal trunk Suction Thrombectomy 6f Pronto extraction catheter- 37184
Right mid superficial femoral artery Suction Thrombectomy 6f Pronto extraction catheter-37184-51(?) OR do I use 37185? ( because this is a different family do I assign the primary again?

Total contrast:
Isovue 105 ml Q9967 x105
Total Medication:
Heparin 5000 units J1644 x5
Lidocaine 1% + Epinephrine 1:100,000 3 mL
Versed 1 mg -J2250
Fentanyl 100 mg J3010x50
Total Sedation:
65.6 min
Sedation: The patient was given conscious sedation by a registered nurse with me in attendance. The
agents used were fentanyl and Versed. There was continuous monitoring of EKG, blood pressure and pulse
oximetry. Total time for conscious sedation was 65.6mins 99152, 99153 x3
 
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