Renal cath

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PROCEDURE: Informed consent was obtained; the patient understood the risks, benefits and alternatives of the procedure and agreed to proceed with the procedure. The left wrist was prepped in a sterile fashion and 2% lidocaine infused subcutaneously until adequate anesthesia was obtained. Left radial artery accessed using modified Seldinger technique. A 6-French 250 mm Glidesheath placed without complication. A 6-French MPA 1 guide catheter was used for selective placement into the second order vessel of the bilateral renal arteries. Angiomax was used for effective anticoagulation of the right renal artery. It was identified as having 70% stenosis with catheter dampening upon engagement. A Runthrough wire was placed distally, and a 5.0 x 12 Herculink bare-metal stent was then deployed to 6 atmospheres with an excellent angiographic result and TIMI-III flow in 0% residual stenosis. Attention was then drawn to the left renal artery which was selectively engaged with second order catheter placement and angiography revealed 95% proximal stenosis. A Runthrough wire was placed distally. A 2.5 x 12 balloon was used for renal angioplasty. There was a suboptimal result with 70% residual stenosis and therefore a 5.0 x 15 Herculink bare-metal stent was then deployed to 7 atmospheres with an excellent angiographic result, TIMI-III flow in 0% residual stenosis.
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SUMMARY: Successful bilateral renal artery stenting.
Not sure if the Cath code is 36254
 

merjim_m@yahoo.com

Contributor
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PROCEDURE: Informed consent was obtained; the patient understood the risks, benefits and alternatives of the procedure and agreed to proceed with the procedure. The left wrist was prepped in a sterile fashion and 2% lidocaine infused subcutaneously until adequate anesthesia was obtained. Left radial artery accessed using modified Seldinger technique. A 6-French 250 mm Glidesheath placed without complication. A 6-French MPA 1 guide catheter was used for selective placement into the second order vessel of the bilateral renal arteries. Angiomax was used for effective anticoagulation of the right renal artery. It was identified as having 70% stenosis with catheter dampening upon engagement. A Runthrough wire was placed distally, and a 5.0 x 12 Herculink bare-metal stent was then deployed to 6 atmospheres with an excellent angiographic result and TIMI-III flow in 0% residual stenosis. Attention was then drawn to the left renal artery which was selectively engaged with second order catheter placement and angiography revealed 95% proximal stenosis. A Runthrough wire was placed distally. A 2.5 x 12 balloon was used for renal angioplasty. There was a suboptimal result with 70% residual stenosis and therefore a 5.0 x 15 Herculink bare-metal stent was then deployed to 7 atmospheres with an excellent angiographic result, TIMI-III flow in 0% residual stenosis.
.
SUMMARY: Successful bilateral renal artery stenting.
Not sure if the Cath code is 36254


Yes, I it mentioned second order of bilateral renal arteries.

Jim - CPC-P
 

Jim Pawloski

True Blue
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PROCEDURE: Informed consent was obtained; the patient understood the risks, benefits and alternatives of the procedure and agreed to proceed with the procedure. The left wrist was prepped in a sterile fashion and 2% lidocaine infused subcutaneously until adequate anesthesia was obtained. Left radial artery accessed using modified Seldinger technique. A 6-French 250 mm Glidesheath placed without complication. A 6-French MPA 1 guide catheter was used for selective placement into the second order vessel of the bilateral renal arteries. Angiomax was used for effective anticoagulation of the right renal artery. It was identified as having 70% stenosis with catheter dampening upon engagement. A Runthrough wire was placed distally, and a 5.0 x 12 Herculink bare-metal stent was then deployed to 6 atmospheres with an excellent angiographic result and TIMI-III flow in 0% residual stenosis. Attention was then drawn to the left renal artery which was selectively engaged with second order catheter placement and angiography revealed 95% proximal stenosis. A Runthrough wire was placed distally. A 2.5 x 12 balloon was used for renal angioplasty. There was a suboptimal result with 70% residual stenosis and therefore a 5.0 x 15 Herculink bare-metal stent was then deployed to 7 atmospheres with an excellent angiographic result, TIMI-III flow in 0% residual stenosis.
.
SUMMARY: Successful bilateral renal artery stenting.
Not sure if the Cath code is 36254

I really don't see a diagnostic arteriogram, so I would bill for it. I would charge 37236-RT for the right renal, and 37236-LT-59 for the left renal (renal angio on the left a roadmap for stent placement?).

HTH,
Jim Pawloski, CIRCC
 
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