amym
Guest
Should this be coded as 92928-LD or 92923-LD? Can I bill anything else?
PROCEDURES PERFORMED:
-- Saphenous vein graft angiography.
-- Coronary Drug Eluding Stent Placement.
-- Coronary Stent Placement.
CORONARY VESSELS: 1st diagonal: There was a 99 % stenosis. There was TIMI
grade 1 flow through the vessel (slow flow without perfusion). This lesion
is a likely culprit for the patient's recent myocardial infarction. An
intervention was performed. Graft to the 1st diagonal: The graft was a
saphenous vein graft from the aorta. There was a tubular 85 % stenosis in
the proximal third of the graft. There was TIMI grade 1 flow through the
graft (slow flow without perfusion). This lesion is a likely culprit for
the patient's recent myocardial infarction.
PROCEDURE:
-- Right femoral artery access. The puncture site was infiltrated with
local anesthetic. The vessel was accessed using the modified Seldinger
technique, a wire was threaded into the vessel, and a sheath was advanced
over the wire into the vessel.
-- Saphenous vein graft angiography. A catheter was advanced to the aorta
and positioned at the aortic anastomosis of the graft under fluoroscopic
guidance. Angiography was performed in multiple projections using
hand-injection of contrast.
LESION INTERVENTION:
-- , using a Emerge 2.25 x 8mm balloon, with 1 inflations and a maximum
inflation pressure of 14 atm.
-- A PROMUS 2.25 x 16 drug-eluting stent at a maximum inflation pressure
of 10 atm was deployed in the SVG to D1
-- PTCA of D1 using a SPRINTER LEGEND OTW 1.25 X 15 balloon, with 3
inflations and a maximum inflation pressure of 15 atm.
STUDY DIAGRAM
Angiographic findings
Native coronary lesions:
7D1: Lesion 1: 99 % stenosis.
Coronary graft lesions:
7Graft to D1: SVG 7 Proximal 1/3 lesion 1: 85 % stenosis in proximal
graft, tubular, culprit lesion.
HEMODYNAMIC TABLES
Pressures: Baseline
Pressures: - HR: 101
Pressures: - Rhythm:
Pressures: -- Aortic Pressure (S/D/M): 141/77/104
PROCEDURES PERFORMED:
-- Saphenous vein graft angiography.
-- Coronary Drug Eluding Stent Placement.
-- Coronary Stent Placement.
CORONARY VESSELS: 1st diagonal: There was a 99 % stenosis. There was TIMI
grade 1 flow through the vessel (slow flow without perfusion). This lesion
is a likely culprit for the patient's recent myocardial infarction. An
intervention was performed. Graft to the 1st diagonal: The graft was a
saphenous vein graft from the aorta. There was a tubular 85 % stenosis in
the proximal third of the graft. There was TIMI grade 1 flow through the
graft (slow flow without perfusion). This lesion is a likely culprit for
the patient's recent myocardial infarction.
PROCEDURE:
-- Right femoral artery access. The puncture site was infiltrated with
local anesthetic. The vessel was accessed using the modified Seldinger
technique, a wire was threaded into the vessel, and a sheath was advanced
over the wire into the vessel.
-- Saphenous vein graft angiography. A catheter was advanced to the aorta
and positioned at the aortic anastomosis of the graft under fluoroscopic
guidance. Angiography was performed in multiple projections using
hand-injection of contrast.
LESION INTERVENTION:
-- , using a Emerge 2.25 x 8mm balloon, with 1 inflations and a maximum
inflation pressure of 14 atm.
-- A PROMUS 2.25 x 16 drug-eluting stent at a maximum inflation pressure
of 10 atm was deployed in the SVG to D1
-- PTCA of D1 using a SPRINTER LEGEND OTW 1.25 X 15 balloon, with 3
inflations and a maximum inflation pressure of 15 atm.
STUDY DIAGRAM
Angiographic findings
Native coronary lesions:
7D1: Lesion 1: 99 % stenosis.
Coronary graft lesions:
7Graft to D1: SVG 7 Proximal 1/3 lesion 1: 85 % stenosis in proximal
graft, tubular, culprit lesion.
HEMODYNAMIC TABLES
Pressures: Baseline
Pressures: - HR: 101
Pressures: - Rhythm:
Pressures: -- Aortic Pressure (S/D/M): 141/77/104
