KQuinones0111
Contributor
I want to make sure I am coding these correctly.
PROCEDURE:
1. Ultrasound guidance for left common femoral artery access.
2. Right femoral angiogram with runoff with a sheath in the right common femoral artery.
3. Mechanical thrombectomy of the right superficial femoral artery.
4. Mechanical thrombectomy of the right profunda artery.
5. Angioplasty of the right profunda artery.
6. Perclose deployment to the left common femoral artery.
7. Moderate sedation for 60 minutes using Versed and fentaNYL.
U/S was used to identify the left common femoral artery. Under u/s guidance, a 5-French sheath was inserted in the left common femoral artery, , using a micropuncture kit and u/s guidance. Images were saved in archives. glidewire was advanced through the left common femoral sheath, into the abdominal aorta. A pigtail catheter was advanced over the Glidewire into the distal abdominal aorta. Angiogram was performed of the pelvic vessels. Glidewire was advanced through the pigtail catheter into the right common femoral artery. Pigtail catheter removed, 5-French removed. An 8-French 45 cm Destiny sheath was advanced over the guidewire into position at the right common femoral artery. The patient received a total of 10,000 units of heparin through the procedure. The Glidewire was advanced through an angled glide catheter used to cross the total occlusion in the distal right common femoral artery into the right superficial femoral artery. A CAT8 Penumbra catheter was advanced over the Glidewire into the right superficial femoral artery. Mechanical thrombectomy was performed. There was partial improvement of flow, but total occlusion remained. A repeat mechanical thrombectomy was performed of the right superficial femoral artery with flow improvement.
Next, the Glidewire was advanced into the right profunda artery and the CAT8 catheter was used to perform mechanical thrombectomy of the right profunda artery. Flow was reestablished; however, there was a filling defect in the middle right profunda artery. The Glidewire was advanced across the occlusion. A 6 x 40 mm balloon was used to dilate the proximal right profunda artery at 8 atmospheres. There was good flow in the right common femoral artery and profunda artery. There was a filling defect in the proximal right superficial femoral artery multiple attempts at crossing the right superficial femoral artery was unsuccessful; however, right superficial femoral artery did fill via collaterals. Final angiogram revealed there was good flow in the right common femoral artery, profunda artery, and popliteal artery with 3-vessel runoff. The patient noticed improvement in right leg pain and numbness. Sheaths removed, 8-French sheath removed, Perclose deployed to left common femoral artery with good hemostasis. The patient transferred to recovery room in stable condition.
I used codes:
76937-26
75710-26, RT
37184 - 59, RT
Can I also use in addition, 37185 - RT
37224 - 59, RT
99152
PROCEDURE:
1. Ultrasound guidance for left common femoral artery access.
2. Right femoral angiogram with runoff with a sheath in the right common femoral artery.
3. Mechanical thrombectomy of the right superficial femoral artery.
4. Mechanical thrombectomy of the right profunda artery.
5. Angioplasty of the right profunda artery.
6. Perclose deployment to the left common femoral artery.
7. Moderate sedation for 60 minutes using Versed and fentaNYL.
U/S was used to identify the left common femoral artery. Under u/s guidance, a 5-French sheath was inserted in the left common femoral artery, , using a micropuncture kit and u/s guidance. Images were saved in archives. glidewire was advanced through the left common femoral sheath, into the abdominal aorta. A pigtail catheter was advanced over the Glidewire into the distal abdominal aorta. Angiogram was performed of the pelvic vessels. Glidewire was advanced through the pigtail catheter into the right common femoral artery. Pigtail catheter removed, 5-French removed. An 8-French 45 cm Destiny sheath was advanced over the guidewire into position at the right common femoral artery. The patient received a total of 10,000 units of heparin through the procedure. The Glidewire was advanced through an angled glide catheter used to cross the total occlusion in the distal right common femoral artery into the right superficial femoral artery. A CAT8 Penumbra catheter was advanced over the Glidewire into the right superficial femoral artery. Mechanical thrombectomy was performed. There was partial improvement of flow, but total occlusion remained. A repeat mechanical thrombectomy was performed of the right superficial femoral artery with flow improvement.
Next, the Glidewire was advanced into the right profunda artery and the CAT8 catheter was used to perform mechanical thrombectomy of the right profunda artery. Flow was reestablished; however, there was a filling defect in the middle right profunda artery. The Glidewire was advanced across the occlusion. A 6 x 40 mm balloon was used to dilate the proximal right profunda artery at 8 atmospheres. There was good flow in the right common femoral artery and profunda artery. There was a filling defect in the proximal right superficial femoral artery multiple attempts at crossing the right superficial femoral artery was unsuccessful; however, right superficial femoral artery did fill via collaterals. Final angiogram revealed there was good flow in the right common femoral artery, profunda artery, and popliteal artery with 3-vessel runoff. The patient noticed improvement in right leg pain and numbness. Sheaths removed, 8-French sheath removed, Perclose deployed to left common femoral artery with good hemostasis. The patient transferred to recovery room in stable condition.
I used codes:
76937-26
75710-26, RT
37184 - 59, RT
Can I also use in addition, 37185 - RT
37224 - 59, RT
99152