shescka
Contributor
Hello
I need help, my Dr. is using 32659, 33010 to code his pericardiocentesis procedures. I coded this one as 93458,26 33010 alone, please let me know if I'm right or lost
Thank you in advance
Procedure(s):
LEFT HEART CATHETERIZATION WITH POSSIBLE INTERVENTION/ PERICARDIOCENTESIS
Laterality / Access Site: Right Femoral Artery
Implant(s): None
Clinical Indications: Non ST elevation MI and large pericardial effusion.
Description of procedure #1: LHC
Informed consent signed and placed in chart
Patient was premedicated for iodine allergy
Patient transferred to cath lab room
Prepped and draped in usual sterile fashion
2% lidocaine in right groin
Micropuncture needle used for access right common femoral artery with the Seldinger technique
Micropuncture canula placed
Right iliofemoral angiogram performed, adequate access confirmed
J wire advanced
Micropuncture canula exchanged for a 4-FR sheath
4-FR JL4, 3DRC, Pigtail catheters advanced over the wire
Multiple orthogonal angiogram obtained and reviewed
Procedure finished, patient stable, transferred to recovery where the sheath will be removed and manual compression used for hemostasis.
Findings #1: LHC
1. Left main: Normal.
2. LAD: 40-50% focal stenosis mid segment.
3. Left circumflex coronary artery: Normal.
4. Right coronary artery: Dominant. 30% focal stenosis proximal.
5. LVgram: deferred. LVEDP: 25 mmHg. No gradient across the aortic valve on pullback.
Procedure #2: Pericardiocentesis.
Prepped and draped in usual sterile fashion
2% lidocaine in subxiphoid area
Using the pericardiocentesis needle and under fluoroscopy the pericardial cavity was accessed.
Opening pressure 15 mmHg
Pericardiocentesis catheter advanced over the wire and left in placed
Aproximately 700 cc of bloody fluid were drained and sent for multiple studies.
Catheter left in placed, sutured to the skin
Pressure after draining fluid 4 mmHg
Complications: none
Estimated Blood Loss: 10 cc
Post Operative Condition: Stable
Disposition: Floor
I need help, my Dr. is using 32659, 33010 to code his pericardiocentesis procedures. I coded this one as 93458,26 33010 alone, please let me know if I'm right or lost
Thank you in advance
Procedure(s):
LEFT HEART CATHETERIZATION WITH POSSIBLE INTERVENTION/ PERICARDIOCENTESIS
Laterality / Access Site: Right Femoral Artery
Implant(s): None
Clinical Indications: Non ST elevation MI and large pericardial effusion.
Description of procedure #1: LHC
Informed consent signed and placed in chart
Patient was premedicated for iodine allergy
Patient transferred to cath lab room
Prepped and draped in usual sterile fashion
2% lidocaine in right groin
Micropuncture needle used for access right common femoral artery with the Seldinger technique
Micropuncture canula placed
Right iliofemoral angiogram performed, adequate access confirmed
J wire advanced
Micropuncture canula exchanged for a 4-FR sheath
4-FR JL4, 3DRC, Pigtail catheters advanced over the wire
Multiple orthogonal angiogram obtained and reviewed
Procedure finished, patient stable, transferred to recovery where the sheath will be removed and manual compression used for hemostasis.
Findings #1: LHC
1. Left main: Normal.
2. LAD: 40-50% focal stenosis mid segment.
3. Left circumflex coronary artery: Normal.
4. Right coronary artery: Dominant. 30% focal stenosis proximal.
5. LVgram: deferred. LVEDP: 25 mmHg. No gradient across the aortic valve on pullback.
Procedure #2: Pericardiocentesis.
Prepped and draped in usual sterile fashion
2% lidocaine in subxiphoid area
Using the pericardiocentesis needle and under fluoroscopy the pericardial cavity was accessed.
Opening pressure 15 mmHg
Pericardiocentesis catheter advanced over the wire and left in placed
Aproximately 700 cc of bloody fluid were drained and sent for multiple studies.
Catheter left in placed, sutured to the skin
Pressure after draining fluid 4 mmHg
Complications: none
Estimated Blood Loss: 10 cc
Post Operative Condition: Stable
Disposition: Floor
