sglamuzina
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Could anyone provide any suggestions on the coding of this...
Selective injection of bilateral renal arteries
PTA and stenting of right proximal renal artery using a 6 x 12 mm stent with 0% residual stenosis
abdominal aortography
Patient was brought into the Cath Lab and right common femoral artery was accessed and a 6 French sheath was placed into the right common femoral artery after applying 20 cc of lidocaine. Initially an Omni catheter was placed into the distal abdominal aorta and abdominal aortography was performed. Selective injection of bilateral renal arteries were then performed using a diagnostic JR4.
Left renal artery showed no evidence of stenosis. Right renal artery proximally with at least 50 to 70% stenosis. Pullback of a 6 French catheter from proximal to ostial renal artery and aorta showed more than 40 to 50 mmHg consistent with significant stenosis as documented previously by CTA and duplex ultrasound.
PTA and stenting of right renal artery. We subsequently proceeded with intervention. Heparin was given, 5000 unit. JR4 guide catheter was advanced and placed at the ostium of right renal artery. A 0. 018 wire was advanced and placed into distal renal artery. 6 x 12 mm biliary stent was advanced and placed across the stenotic lesion from ostium to proximal right renal artery. After confirmation position of the stent, stent was deployed. Post angioplasty angiography showed 0% residual with good apposition of the stent. Pullback with 6 French guide catheter showed no gradient. Since stent appeared to be fully opposed with no evidence of mall apposition, patient was not postdilated.
Right common femoral arteriography was performed and 6 French Angio-Seal closure device was used to seal the puncture site. This was done without any difficulty. Patient remained stable throughout the procedure. She did have some pain at the groin site which was treated with multiple doses of fentanyl and Versed.
Selective injection of bilateral renal arteries
PTA and stenting of right proximal renal artery using a 6 x 12 mm stent with 0% residual stenosis
abdominal aortography
Patient was brought into the Cath Lab and right common femoral artery was accessed and a 6 French sheath was placed into the right common femoral artery after applying 20 cc of lidocaine. Initially an Omni catheter was placed into the distal abdominal aorta and abdominal aortography was performed. Selective injection of bilateral renal arteries were then performed using a diagnostic JR4.
Left renal artery showed no evidence of stenosis. Right renal artery proximally with at least 50 to 70% stenosis. Pullback of a 6 French catheter from proximal to ostial renal artery and aorta showed more than 40 to 50 mmHg consistent with significant stenosis as documented previously by CTA and duplex ultrasound.
PTA and stenting of right renal artery. We subsequently proceeded with intervention. Heparin was given, 5000 unit. JR4 guide catheter was advanced and placed at the ostium of right renal artery. A 0. 018 wire was advanced and placed into distal renal artery. 6 x 12 mm biliary stent was advanced and placed across the stenotic lesion from ostium to proximal right renal artery. After confirmation position of the stent, stent was deployed. Post angioplasty angiography showed 0% residual with good apposition of the stent. Pullback with 6 French guide catheter showed no gradient. Since stent appeared to be fully opposed with no evidence of mall apposition, patient was not postdilated.
Right common femoral arteriography was performed and 6 French Angio-Seal closure device was used to seal the puncture site. This was done without any difficulty. Patient remained stable throughout the procedure. She did have some pain at the groin site which was treated with multiple doses of fentanyl and Versed.