margaret fahy
Guru
Hi guys,
I coded this as one unit of 61626, but i want to be sure this is considered just one operative field.
Input please?
PERCUTANEOUS NASOPHARYNGEAL FIBROMA EMBOLIZATION:
Under direct visualization an 22-gauge, 3.5 inch spinal needle
was inserted into the anterior portion of the tumor via the
Caldwell Luc defect lateral cheek and sinus region, by Dr. Buzi
ENT and a slip tip T connector was attached.
The position of the needle was adjusted under fluoroscopic
guidance. Contrast was injected. This demonstrated tumor blush.
Then embolization was performed using Onyx 18 as per protocol
under roadmapping guidance. Two additional sited were chosen
in the region of the deep and anterior temporal circulation
and contrast was injected. This demonstrated tumor blush.
Then embolization was performed using Onyx 18 as per protocol
under roadmapping guidance.
Post embolization external carotid angiography demonstrated
significant reduction in the tumor blush to the treated regions
of the distal IMAX and temporal regions.
RIGHT ASCENDING PHARYNGEAL ARTERY PVA EMBOLIZATION:
Selective embolization of the ascending pharyngeal supply was
performed with a Marathon microcatheter and echelon guidewire
and 1ml of 150-250 micron PVA was instilled to stasis. Post
embolization RECA and RCCA angiography demonstrated significant
reduction in the RECA and RCCA tumor blush.
The catheter and the sheath were removed and manual compression
was applied until hemostasis was achieved. A saline occlusive
dressing was applied.There where no immediate complications
associated with the procedure. The patient left the IR suite in
stable condition. Dr. Cahill and Dr Hurst were present was
present throughout the procedure and both performed the
angiography and embolization equally.
I coded this as one unit of 61626, but i want to be sure this is considered just one operative field.
Input please?
PERCUTANEOUS NASOPHARYNGEAL FIBROMA EMBOLIZATION:
Under direct visualization an 22-gauge, 3.5 inch spinal needle
was inserted into the anterior portion of the tumor via the
Caldwell Luc defect lateral cheek and sinus region, by Dr. Buzi
ENT and a slip tip T connector was attached.
The position of the needle was adjusted under fluoroscopic
guidance. Contrast was injected. This demonstrated tumor blush.
Then embolization was performed using Onyx 18 as per protocol
under roadmapping guidance. Two additional sited were chosen
in the region of the deep and anterior temporal circulation
and contrast was injected. This demonstrated tumor blush.
Then embolization was performed using Onyx 18 as per protocol
under roadmapping guidance.
Post embolization external carotid angiography demonstrated
significant reduction in the tumor blush to the treated regions
of the distal IMAX and temporal regions.
RIGHT ASCENDING PHARYNGEAL ARTERY PVA EMBOLIZATION:
Selective embolization of the ascending pharyngeal supply was
performed with a Marathon microcatheter and echelon guidewire
and 1ml of 150-250 micron PVA was instilled to stasis. Post
embolization RECA and RCCA angiography demonstrated significant
reduction in the RECA and RCCA tumor blush.
The catheter and the sheath were removed and manual compression
was applied until hemostasis was achieved. A saline occlusive
dressing was applied.There where no immediate complications
associated with the procedure. The patient left the IR suite in
stable condition. Dr. Cahill and Dr Hurst were present was
present throughout the procedure and both performed the
angiography and embolization equally.
