I'm not sure how to code the following report. Would I use 75791, 75978, and 35476 only? or is there another code also?
Left upper extremity dialysis shuntogram. Angioplasty of arterial anastomosis.
Angioplasty of venous anastomosis.
6/24/2015
History. Clotted access.
Using standard aseptic technique an 18-gauge Angiocath was placed into the
arterial side of the left upper arm dialysis graft. Contrast injection
demonstrated antegrade flow through the graft. No intragraft thrombus or
aneurysm. Tight stenosis, greater than 70% luminal diameter are seen at both the
arterial and venous anastomoses. No central venous stenosis.
Informed consent obtained. Using standard aseptic Seldinger technique under 1%
lidocaine local anesthesia, the indwelling Angiocath was exchanged over a wire
for a Kumpe catheter which was advanced over the wire into the brachial artery
then exchanged over the wire for 6 French sheath. A 6 x 40 mm angioplasty
balloon was inserted through the sheath over a wire. Patient received 3000 units
IV heparin and 50 mcg IV fentanyl. Angioplasty of the arterial anastomosis was
performed with good result and no complication.
Using standard aseptic Seldinger technique under 1% lidocaine local anesthesia
and a micropuncture set, a second 6 French sheath was placed into the venous
side of the graft. A Kumpe catheter and guidewire were placed through the
sheath, manipulated across the venous anastomosis stenosis, and then exchanged
for a 7 x 40 mm balloon. The venous anastomosis was dilated successfully, with
no significant residual stenosis and no complication.
Patient tolerated the procedure well. Patient was taken to outpatient
observation in stable condition.
Left upper extremity dialysis shuntogram. Angioplasty of arterial anastomosis.
Angioplasty of venous anastomosis.
6/24/2015
History. Clotted access.
Using standard aseptic technique an 18-gauge Angiocath was placed into the
arterial side of the left upper arm dialysis graft. Contrast injection
demonstrated antegrade flow through the graft. No intragraft thrombus or
aneurysm. Tight stenosis, greater than 70% luminal diameter are seen at both the
arterial and venous anastomoses. No central venous stenosis.
Informed consent obtained. Using standard aseptic Seldinger technique under 1%
lidocaine local anesthesia, the indwelling Angiocath was exchanged over a wire
for a Kumpe catheter which was advanced over the wire into the brachial artery
then exchanged over the wire for 6 French sheath. A 6 x 40 mm angioplasty
balloon was inserted through the sheath over a wire. Patient received 3000 units
IV heparin and 50 mcg IV fentanyl. Angioplasty of the arterial anastomosis was
performed with good result and no complication.
Using standard aseptic Seldinger technique under 1% lidocaine local anesthesia
and a micropuncture set, a second 6 French sheath was placed into the venous
side of the graft. A Kumpe catheter and guidewire were placed through the
sheath, manipulated across the venous anastomosis stenosis, and then exchanged
for a 7 x 40 mm balloon. The venous anastomosis was dilated successfully, with
no significant residual stenosis and no complication.
Patient tolerated the procedure well. Patient was taken to outpatient
observation in stable condition.