KareteVijiTeja
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Hello,
I need suggestion regarding below OP report
PROCEDURE DONE:
Ultrasound- guided access of the bilateral common femoral arteries,
Percutaneous retrograde cannulation of the left common femoral artery with a 7 French sheath,
Percutaneous retrograde cannulation of the right common femoral artery with a 9 French sheath,
Pre deployment of Perclose device to the right common femoral arteries x 2
Pre deployment of Perclose device to the left common femoral artery x1
Aortogram and bilateral iliacgram,
Intravascular ultrasound,
Ultrasonic Shockwave balloon angioplasty using 7 x 60 X 2 to the distal aorta and bilateral
common iliac arteries,
Serial dilation of the right common iliac artery using 14 French , 18 French dilator,
Deployment of a FX device 22 X 40 bifurcated graft to the distal aorta and bilateral common iliac
arteries,
Balloon angioplasty using Q 50 balloon,
Deployment of VBX stents 8 x 59 to the right iliac artery and 8 x 39 into the left iliac artery,
Post deployment balloon angioplasty,
Completion angiogram,
Closure of the bilateral common femoral arteries using Perclose device.
PROCEDURE:
The patient was brought to the operating room and identified. Under local MAC suitable
monitoring lines were placed. The patient was prepped and draped in standard sterile
fashion. Under ultrasound guidance bilateral common femoral artery was accessed using
a micropuncture needle using a modified Seldinger technique percutaneous retrograde
cannulation of the bilateral common femoral arteries were done on the left with 7 French
sheath on the right was 9 French sheath. The patient also had a pre deployment of
Perclose device x2 on the right , x1 on the left. She was systematically heparinized.
Pigtail catheter was positioned above the level of the renal arteries and an aortogram and
bilateral iliacgram was done that showed a patent bilateral renal arteries. Infrarenal aorta
showed severe atherosclerotic changes. Bilateral common iliac arteries are patent on the
left hypogastric artery is patent and the external iliac arteries were not clearly visualized
and bilaterally the sheaths were found to be nearly occlusive. Patient had an intravascular
ultrasound done to bilateral common iliac arteries and as well as the distal aorta and the
measurements were taken.
We elected to move forward with a ultrasonic shockwave balloon angioplasty using 7 x 60
balloon to the distal aorta and as well as the bilateral common iliac arteries and total of 300
pulses was each utilized on both balloons. Following which the the balloons were
withdrawn. The right common iliac artery was serially dilated using 14 ,16 and as well as
the 18 fr dilators.
A FX device 22 X 40 was deployed in the optimal position. Q 50 balloon was used for
balloon angioplasty. Patient still had bilateral common iliac arteries residual stenosis. we
elected to move forward with a 8 x 59 VBX stent to the right and 8 x 39 stent to the left
common iliac arteries. Following which the pigtail catheter was positioned in the
infrarenal aorta and completion angiogram was done, that showed a patent aortoiliac graft
without evidence of any endoleaks. Following which the sheaths were withdrawn and
bilateral common femoral arteries were closed using the Perclose device. On the right the
patient received an additional 6 Angio- Seal as well. Pressure was held in the right
common femoral artery for a total period of 20 minutes and pressure dressing was
applied. Protamine was given to reverse the effects of the heparin. Following the
procedure the patient was transferred to the recovery area stable vitals and no
complications. Dr. XXXXXX and myself was scrubbed and present the entirety of the crisis
and both offers did critical portions of the case.
The provider I'm billing acting as Co-surgeon. the codes i come up with are 37221-50,37236-59,37252. Can anyone help me out how to code this procedure for co-surgeon?
Thank you in advance!
I need suggestion regarding below OP report
PROCEDURE DONE:
Ultrasound- guided access of the bilateral common femoral arteries,
Percutaneous retrograde cannulation of the left common femoral artery with a 7 French sheath,
Percutaneous retrograde cannulation of the right common femoral artery with a 9 French sheath,
Pre deployment of Perclose device to the right common femoral arteries x 2
Pre deployment of Perclose device to the left common femoral artery x1
Aortogram and bilateral iliacgram,
Intravascular ultrasound,
Ultrasonic Shockwave balloon angioplasty using 7 x 60 X 2 to the distal aorta and bilateral
common iliac arteries,
Serial dilation of the right common iliac artery using 14 French , 18 French dilator,
Deployment of a FX device 22 X 40 bifurcated graft to the distal aorta and bilateral common iliac
arteries,
Balloon angioplasty using Q 50 balloon,
Deployment of VBX stents 8 x 59 to the right iliac artery and 8 x 39 into the left iliac artery,
Post deployment balloon angioplasty,
Completion angiogram,
Closure of the bilateral common femoral arteries using Perclose device.
PROCEDURE:
The patient was brought to the operating room and identified. Under local MAC suitable
monitoring lines were placed. The patient was prepped and draped in standard sterile
fashion. Under ultrasound guidance bilateral common femoral artery was accessed using
a micropuncture needle using a modified Seldinger technique percutaneous retrograde
cannulation of the bilateral common femoral arteries were done on the left with 7 French
sheath on the right was 9 French sheath. The patient also had a pre deployment of
Perclose device x2 on the right , x1 on the left. She was systematically heparinized.
Pigtail catheter was positioned above the level of the renal arteries and an aortogram and
bilateral iliacgram was done that showed a patent bilateral renal arteries. Infrarenal aorta
showed severe atherosclerotic changes. Bilateral common iliac arteries are patent on the
left hypogastric artery is patent and the external iliac arteries were not clearly visualized
and bilaterally the sheaths were found to be nearly occlusive. Patient had an intravascular
ultrasound done to bilateral common iliac arteries and as well as the distal aorta and the
measurements were taken.
We elected to move forward with a ultrasonic shockwave balloon angioplasty using 7 x 60
balloon to the distal aorta and as well as the bilateral common iliac arteries and total of 300
pulses was each utilized on both balloons. Following which the the balloons were
withdrawn. The right common iliac artery was serially dilated using 14 ,16 and as well as
the 18 fr dilators.
A FX device 22 X 40 was deployed in the optimal position. Q 50 balloon was used for
balloon angioplasty. Patient still had bilateral common iliac arteries residual stenosis. we
elected to move forward with a 8 x 59 VBX stent to the right and 8 x 39 stent to the left
common iliac arteries. Following which the pigtail catheter was positioned in the
infrarenal aorta and completion angiogram was done, that showed a patent aortoiliac graft
without evidence of any endoleaks. Following which the sheaths were withdrawn and
bilateral common femoral arteries were closed using the Perclose device. On the right the
patient received an additional 6 Angio- Seal as well. Pressure was held in the right
common femoral artery for a total period of 20 minutes and pressure dressing was
applied. Protamine was given to reverse the effects of the heparin. Following the
procedure the patient was transferred to the recovery area stable vitals and no
complications. Dr. XXXXXX and myself was scrubbed and present the entirety of the crisis
and both offers did critical portions of the case.
The provider I'm billing acting as Co-surgeon. the codes i come up with are 37221-50,37236-59,37252. Can anyone help me out how to code this procedure for co-surgeon?
Thank you in advance!