JenReyn99
Guru
These are still really confusing me! I'm still learning, but I have no resources and have had no training on when to use selective vs. non-selective codes, and which arteries are covered as first, second and third order. I've come a long way since I started working these, but still have a lot to learn. So any help with what codes would be for the following is greatly appreciated!
"....The right groin was prepped in usual sterile fashion and draped. A surgical timeout was performed. Anesthetize the soft tissues to 4 ml 1% lidocaine. I accessed the common femoral artery with a 21-guage micropuncture needle.
Needle was exchanged over guidewire for a dilator which was then exchanged over guidewire for 6 French sheath. Using a 4 French Levin catheter I was able to catheterize the superior mesenteric artery. This revealed a replaced right hepatic artery. I do not see any active extravasation of contrast upon injection of the SMA. I then proceeded with catheterizing ther celiac trunk.
Moderate localized the select trunk had difficulty placing a catheter into the vessel. I then placed an Omni Flush catheter into the aorta and performed an aortogram. This revealed the select trunk with stenotic at its origin. I then subsequently was able to catheterize the proximal select trunk with a variety of catheters including a Levin catheter and Cobra catheter however was unable to pass a catheter beyond stenosis. I attempted with a SOS catheter without success. I then catheterized the left common femoral artery from a contralateral approach and performed a Simmons 2 catheter. While I was able to catheterize the lateral celiac trunk was unable to seat the catheter beyond the stenotic segment. This precluded empiric embolization of the GDA.
The catheters and wires removed and the sheath was sutured in place patient was discharged intensive care unit for supportive care. "
Seriously, I appreciate any insight and help. Thanks!
"....The right groin was prepped in usual sterile fashion and draped. A surgical timeout was performed. Anesthetize the soft tissues to 4 ml 1% lidocaine. I accessed the common femoral artery with a 21-guage micropuncture needle.
Needle was exchanged over guidewire for a dilator which was then exchanged over guidewire for 6 French sheath. Using a 4 French Levin catheter I was able to catheterize the superior mesenteric artery. This revealed a replaced right hepatic artery. I do not see any active extravasation of contrast upon injection of the SMA. I then proceeded with catheterizing ther celiac trunk.
Moderate localized the select trunk had difficulty placing a catheter into the vessel. I then placed an Omni Flush catheter into the aorta and performed an aortogram. This revealed the select trunk with stenotic at its origin. I then subsequently was able to catheterize the proximal select trunk with a variety of catheters including a Levin catheter and Cobra catheter however was unable to pass a catheter beyond stenosis. I attempted with a SOS catheter without success. I then catheterized the left common femoral artery from a contralateral approach and performed a Simmons 2 catheter. While I was able to catheterize the lateral celiac trunk was unable to seat the catheter beyond the stenotic segment. This precluded empiric embolization of the GDA.
The catheters and wires removed and the sheath was sutured in place patient was discharged intensive care unit for supportive care. "
Seriously, I appreciate any insight and help. Thanks!