bhargavi
Guru
Conclusion
After obtaining informed consent, the patient was prepped and draped in the usual fashion. As the patient was under general anesthesia, no conscious sedation was administered. Likewise, we did not utilize local anesthesia to the site. Under fluoroscopic guidance, and using modified Seldinger technique, a 5 French arterial sheath was placed without difficulty into the left femoral artery. We then obtained a 4 French contra catheter which was positioned in the distal abdominal aorta. We then performed nonselective digital subtraction angiography of the distal abdominal aorta with bilateral iliofemoral runoff. This revealed patent bilateral common, internal, and external iliac vessels. There was evidence of blush at the level of this and common femoral artery consistent with the patient's known pseudoaneurysm. Through the contra catheter, we advanced a 180 cm 0.035 inch stiff angled tip zip wire. This allowed for selective engagement of the distal external iliac artery with this catheter. Following this, we removed the zip wire and advanced a 180 cm 0.035 inch Magic torque wire into the SFA. The contra catheter and 5 French sheath were withdrawn and replaced with a 6 x 45 cm destination sheath. We then performed selective angiography once again of the right iliofemoral system. We redemonstrated the pseudoaneurysm. We then obtained a 9 x 20 mm Mustang balloon which we utilized for proximal balloon occlusion at and just below the level of the hypogastric artery in order to provide protection for repair of the pseudoaneurysm. Following completion of the repair, the balloon was deflated and the balloon and wire were withdrawn. The destination sheath was then advanced into the descending thoracic or abdominal aorta for the remainder of the TAVR procedure.
At the end of the procedure, digital subtraction angiography of the bilateral iliofemoral system revealed an excellent result in the common femoral artery on the right. We then concluded the procedure.
Impression:
1. Right common femoral pseudoaneurysm, status post proximal balloon occlusion and surgical repair.
this procedure was done along with tavr cpt 33361
thanks in advance
can i bill 75716, 37224?
i am a hospital coder
After obtaining informed consent, the patient was prepped and draped in the usual fashion. As the patient was under general anesthesia, no conscious sedation was administered. Likewise, we did not utilize local anesthesia to the site. Under fluoroscopic guidance, and using modified Seldinger technique, a 5 French arterial sheath was placed without difficulty into the left femoral artery. We then obtained a 4 French contra catheter which was positioned in the distal abdominal aorta. We then performed nonselective digital subtraction angiography of the distal abdominal aorta with bilateral iliofemoral runoff. This revealed patent bilateral common, internal, and external iliac vessels. There was evidence of blush at the level of this and common femoral artery consistent with the patient's known pseudoaneurysm. Through the contra catheter, we advanced a 180 cm 0.035 inch stiff angled tip zip wire. This allowed for selective engagement of the distal external iliac artery with this catheter. Following this, we removed the zip wire and advanced a 180 cm 0.035 inch Magic torque wire into the SFA. The contra catheter and 5 French sheath were withdrawn and replaced with a 6 x 45 cm destination sheath. We then performed selective angiography once again of the right iliofemoral system. We redemonstrated the pseudoaneurysm. We then obtained a 9 x 20 mm Mustang balloon which we utilized for proximal balloon occlusion at and just below the level of the hypogastric artery in order to provide protection for repair of the pseudoaneurysm. Following completion of the repair, the balloon was deflated and the balloon and wire were withdrawn. The destination sheath was then advanced into the descending thoracic or abdominal aorta for the remainder of the TAVR procedure.
At the end of the procedure, digital subtraction angiography of the bilateral iliofemoral system revealed an excellent result in the common femoral artery on the right. We then concluded the procedure.
Impression:
1. Right common femoral pseudoaneurysm, status post proximal balloon occlusion and surgical repair.
this procedure was done along with tavr cpt 33361
thanks in advance
can i bill 75716, 37224?
i am a hospital coder