Wiki Please help! Procedure coding

leo061108

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Please help!.. I am not sure about this, any help will be appreciated!!
I am in a Cardiology specialists office and my physician performed this at the hospital..


Reason for Exam: Other - Please see comments; Peripheral vascular Disease

INTERPRETATION PROCEDURE:
1. Unilateral extremity angiography, right.
2. AngioJet thrombectomy, right popliteal.
3. PTA, right popliteal.
4. Thrombolytic drip, right lower extremity.
5. Infusion catheter placement, right popliteal.

PROCEDURE PERFORMED: After consent was obtained by detailing associated risks and benefits as well as alternative therapy, the patient elected to proceed to angiogram and angioplasty. The right femoral area was prepped and draped in the normal sterile fashion. The right femoral artery was cannulated via modified Seldinger technique with placement of a 6-French antegrade sheath. All catheter exchanges through the sheath.

FINDINGS:
1. The iliac system is widely patent, including common, superficial, and deep.
2. Femoral System: The common, superficial, and deep femoral are widely patent.
3. Popliteal: The popliteal artery is totally occluded in the distal aspect. There is no discernible runoff to the foot. This appears to be acute thrombus.

RIGHT POPLITEAL INTERVENTION: We were able to wire this easily with a Choice PT Extra Support wire. The wire would go down the posterior tibial as well as peroneal and anterior tibial. Multiple balloon inflations were made with a 4.0 balloon. This did not improve. There was still a large thrombus burden. We tried mechanical thrombectomy with Penumbra as well as Quick-Cross catheter. We then changed to AngioJet and performed thrombectomy with AngioJet. There was marked improvement. There was flow down all three of the vessels, however, there was still thrombus burden left. An infusion catheter was placed right at the beginning of the popliteal and TPA infusion was undertaken overnight with heparin. Further care depends upon the results with repeat angiography.
 
Last edited:
Look at 37184,RT and 37211,XU,RT. Don't code the PTA because there is no stenosis mentioned and not enough documentation to code the 75710. Dx I74.3. Hope this helps.
 
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