valelim
Contributor
Surgeon performed L2 angio w/embolization for dAVF. He's wanting to bill for 6 super-selective angiographies (75705) and 6 catheterizations (36247) of the branches of the LL2 artery. Can someone review and advise if this is correct?
The patient was positioned supine on the procedure table and carefully padded. General anesthesia provided by the anesthesiology service. Both groins were prepped in sterile manner then the patient draped.
RCFA accessed and a long sheath placed using micropuncture technique with US and fluoroscopic guidance.
Diagnostic catheter advanced over the glidewire into the aorta.
LL2 lumbar artery selected. Angiograms performed and reviewed. Long sheath advanced over the diagnostic catheter over glidewire into LL2 lumbar artery. Diagnostic catheter removed.
LL2 lumbar artery superselected with microballoon over microwire using roadmapping technique.
LL2 lumbar artery branch 1 superselected with microcatheter over microwire using roadmapping technique. Superselective angiograms performed and reviewed.
LL2 lumbar artery branch 2 superselected with microcatheter over microwire using roadmapping technique. Superselective angiograms performed and reviewed.
LL2 lumbar artery branch 3 superselected with microcatheter over microwire using roadmapping technique. Superselective angiograms performed and reviewed.
LL2 lumbar artery branch 4 superselected with microcatheter over microwire using roadmapping technique. Superselective angiograms performed and reviewed.
LL2 lumbar artery microballoon inflated.
LL2 lumbar artery branch 4 Onyx implanted using blank roadmapping technique.
LL2 lumbar artery microballoon deflated.
LL2 lumbar artery follow up angiograms performed and reviewed.
LL2 lumbar artery branch 5 superselected with microcatheter over microwire using roadmapping technique. Superselective angiograms performed and reviewed.
LL2 lumbar artery microballoon inflated.
LL2 lumbar artery branch 5 Onyx implanted using blank roadmapping technique.
LL2 lumbar artery microballoon deflated.
LL2 lumbar artery follow up angiograms performed and reviewed.
LL2 lumbar artery branch 6 superselected with microcatheter over microwire using roadmapping technique. Superselective angiograms performed and reviewed.
LL2 lumbar artery microballoon inflated.
LL2 lumbar artery branch 6 Onyx implanted using blank roadmapping technique.
LL2 lumbar artery microballoon deflated.
LL2 lumbar artery follow up angiograms performed and reviewed.
LL2 lumbar artery follow up angiograms performed as fiber coils implanted sequentially with microballoon assist in LL2 lumbar artery from distal to mid segment.
LL2 lumbar artery follow up angiograms performed and reviewed.
Microballoon removed.
Long sheath pulled back into aorta.
RCFA long sheath removed over wire. Closure device placed with hemostasis.
Many thanks
The patient was positioned supine on the procedure table and carefully padded. General anesthesia provided by the anesthesiology service. Both groins were prepped in sterile manner then the patient draped.
RCFA accessed and a long sheath placed using micropuncture technique with US and fluoroscopic guidance.
Diagnostic catheter advanced over the glidewire into the aorta.
LL2 lumbar artery selected. Angiograms performed and reviewed. Long sheath advanced over the diagnostic catheter over glidewire into LL2 lumbar artery. Diagnostic catheter removed.
LL2 lumbar artery superselected with microballoon over microwire using roadmapping technique.
LL2 lumbar artery branch 1 superselected with microcatheter over microwire using roadmapping technique. Superselective angiograms performed and reviewed.
LL2 lumbar artery branch 2 superselected with microcatheter over microwire using roadmapping technique. Superselective angiograms performed and reviewed.
LL2 lumbar artery branch 3 superselected with microcatheter over microwire using roadmapping technique. Superselective angiograms performed and reviewed.
LL2 lumbar artery branch 4 superselected with microcatheter over microwire using roadmapping technique. Superselective angiograms performed and reviewed.
LL2 lumbar artery microballoon inflated.
LL2 lumbar artery branch 4 Onyx implanted using blank roadmapping technique.
LL2 lumbar artery microballoon deflated.
LL2 lumbar artery follow up angiograms performed and reviewed.
LL2 lumbar artery branch 5 superselected with microcatheter over microwire using roadmapping technique. Superselective angiograms performed and reviewed.
LL2 lumbar artery microballoon inflated.
LL2 lumbar artery branch 5 Onyx implanted using blank roadmapping technique.
LL2 lumbar artery microballoon deflated.
LL2 lumbar artery follow up angiograms performed and reviewed.
LL2 lumbar artery branch 6 superselected with microcatheter over microwire using roadmapping technique. Superselective angiograms performed and reviewed.
LL2 lumbar artery microballoon inflated.
LL2 lumbar artery branch 6 Onyx implanted using blank roadmapping technique.
LL2 lumbar artery microballoon deflated.
LL2 lumbar artery follow up angiograms performed and reviewed.
LL2 lumbar artery follow up angiograms performed as fiber coils implanted sequentially with microballoon assist in LL2 lumbar artery from distal to mid segment.
LL2 lumbar artery follow up angiograms performed and reviewed.
Microballoon removed.
Long sheath pulled back into aorta.
RCFA long sheath removed over wire. Closure device placed with hemostasis.
Many thanks