Wiki Popliteal Stenting

Pillow1

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This is a big favor..

If anyone has the time to share their expertise I would be very appreciative. I was advised how to code this two entirely different ways including
codes that don't appear to match the lower extremities.
Also the dx: popliteal anuerism (442.3) is not included in the Cardio/Vascular/Thoracic Coding Companion in some of the CPT codes for example 34805 does not allow 442.3.

This is what I came up with:
36245-59LT
36246-LT
34812-LT
34813-LT
35151-LT (would like to use 34805 to describe the stent but it =abdominal)
35474-LT51
75962-26
75710-26(FOLLOW UP ANGIOGRAPHY)

"CARDIAC CATHETERIZATION"

PROCEDURE:
Left SFA/popliteal angiogram and left popliteal stenting with
endovascular Viabahn covered stent.

PREOPERATIVE DIAGNOSIS:
Left popliteal aneurysm.

POSTOPERATIVE DIAGNOSIS:
Left popliteal aneurysm.

DESCRIPTION OF PROCEDURE:
The patient was prepped and draped in the usual sterile fashion.
After adequate local anesthesia with 2% Xylocaine, the left femoral
artery was cannulated with a 4-French sheath. Next, a 6-French
sheath was exchanged and a Perclose device was then deployed, after
which, it was exchanged for a 9-French sheath, and then angiogram was
performed of the left SFA into the popliteal/trifurcation region.
There appeared to be a large left popliteal aneurysm noted. It was
then covered with a 9 x 150 Viabahn endovascular covered stent. It
was then post angioplasties with a 10 mm x ______ mm balloon at both
the distal and proximal tips. Follow-up angiography showed
well-deployed stent. The aneurysm had now resolved. It was well
covered at its origin and at the distal anastomosis site. No
endovascular leak was noted. After which, the Perclose was used to
close the common femoral artery with an excellent result. No
complications were noted.

IMPRESSION:
1. Left popliteal aneurysm.
2. Successful stenting with a Viabahn endovascular covered
stent which was 9 x 150, which successfully covered the entire
aneurysmal segment.
3. Final angiogram showed well-apposed stent struts with no
endovascular leak and excellent/normal flow.
4. Successfully Perclosed at the termination of the procedure
without any complications.

THANK YOU
DENISE (studying for the CPC and CCC / CCVTC exams)
 
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