Ins carrier questioned why both cpt codes are being billed on this report. 36425-59, 36426 and 75736 has been billed but ins denying 36245 as bundled w/ 36246...I don't code for interventional radiology...only receive denials to be corrected for appeal purposes...thank you advance for your help..
Procedure: Continuous physiological monitoring was carried out throughout the procedure. The right groin was prepped and draped in usual sterile fashion. Using a 22 gauge needle access was obtained into the right common femoral artery. A guidewire and omni- flush catheter was placed in the distal abdominal aorta and pelvic angiography was performed in the AP position. The aorta is normal in signs. Exchange was made for a Cobra catheter. Using a Glidewire, access was obtained into the left internal iliac artery. Digital subtraction angiography was performed. There is no evidence of arterial abnormality or extravasation. Next, access was obtained into the right internal iliac artery using a cobra catheter and Glidewire. Digital subtraction angiography demonstrates no evidence of extravasation or hemorrhage. The catheter was removed and the sheath was stitched in place hooked up to arterial line at the request of the trauma team, to be removed later that night. The patient was transferred to the surgical Intensive Care unit.
Conclusion: A pelvic angiogram performed in patient status post pelvic trauma demonstrates no definite extravasation even after selective injections of the left and right internal iliac arteries. The arterial line was left in place to be removed later in the ICU setting.
Procedure: Continuous physiological monitoring was carried out throughout the procedure. The right groin was prepped and draped in usual sterile fashion. Using a 22 gauge needle access was obtained into the right common femoral artery. A guidewire and omni- flush catheter was placed in the distal abdominal aorta and pelvic angiography was performed in the AP position. The aorta is normal in signs. Exchange was made for a Cobra catheter. Using a Glidewire, access was obtained into the left internal iliac artery. Digital subtraction angiography was performed. There is no evidence of arterial abnormality or extravasation. Next, access was obtained into the right internal iliac artery using a cobra catheter and Glidewire. Digital subtraction angiography demonstrates no evidence of extravasation or hemorrhage. The catheter was removed and the sheath was stitched in place hooked up to arterial line at the request of the trauma team, to be removed later that night. The patient was transferred to the surgical Intensive Care unit.
Conclusion: A pelvic angiogram performed in patient status post pelvic trauma demonstrates no definite extravasation even after selective injections of the left and right internal iliac arteries. The arterial line was left in place to be removed later in the ICU setting.