Hello group!
Looking for some input... Would you code as a discontinued procedure or would you just code for the angiography? Need some input, please!
TIA
Melissa Bedford,CPC
PROCEDURE REQUESTED - EMBOLIZATION-TRANSCATHETER
CLINICAL HISTORY: PSEUDOANEURYSM
COMMENTS: SPLENIC ARTERY PSEUDOANEURYSM/PT HERE AT
INDICATION:
48-year-old female with splenic aneurysm or pseudoaneurysm. Endovascular
treatment is planned.
MEDICATIONS: 1% lidocaine for local anesthesia. Intravenous Versed and
fentanyl were administered for monitored moderate sedation.
Technique:
Risks and benefits were discussed with the patient. Patient signed the
informed consent. The right groin was prepped and draped in usual sterile
fashion. The right femoral artery was accessed with a micropuncture
needle under sonographic guidance. Through the needle a 0.018 wire was
advanced. The system was converted to a 5 French sheath over a Bentson
wire using Seldinger technique. A Chung C catheter was then advanced to
the celiac axis. A digital subtraction angiography of the celiac axis
revealed approximately 1 cm aneurysm involving the distal aspect of the
splenic artery. The mouth of the aneurysm measures roughly 4.5 mm. The
mouth of the aneurysm is somewhat larger than expected and the coils on
hand are not deemed appropriate for treatment. Therefore the procedure
was terminated. Hemostasis was achieved at the right groin with a FemStop
device. The patient was discharged home after six hours of observation.
COMPLICATIONS: None immediate.
IMPRESSION:
1. 1 cm splenic aneurysm involving the distal splenic artery. The patient
will be rescheduled for treatment with detachable endovascular coils.
Looking for some input... Would you code as a discontinued procedure or would you just code for the angiography? Need some input, please!
TIA
Melissa Bedford,CPC
PROCEDURE REQUESTED - EMBOLIZATION-TRANSCATHETER
CLINICAL HISTORY: PSEUDOANEURYSM
COMMENTS: SPLENIC ARTERY PSEUDOANEURYSM/PT HERE AT
INDICATION:
48-year-old female with splenic aneurysm or pseudoaneurysm. Endovascular
treatment is planned.
MEDICATIONS: 1% lidocaine for local anesthesia. Intravenous Versed and
fentanyl were administered for monitored moderate sedation.
Technique:
Risks and benefits were discussed with the patient. Patient signed the
informed consent. The right groin was prepped and draped in usual sterile
fashion. The right femoral artery was accessed with a micropuncture
needle under sonographic guidance. Through the needle a 0.018 wire was
advanced. The system was converted to a 5 French sheath over a Bentson
wire using Seldinger technique. A Chung C catheter was then advanced to
the celiac axis. A digital subtraction angiography of the celiac axis
revealed approximately 1 cm aneurysm involving the distal aspect of the
splenic artery. The mouth of the aneurysm measures roughly 4.5 mm. The
mouth of the aneurysm is somewhat larger than expected and the coils on
hand are not deemed appropriate for treatment. Therefore the procedure
was terminated. Hemostasis was achieved at the right groin with a FemStop
device. The patient was discharged home after six hours of observation.
COMPLICATIONS: None immediate.
IMPRESSION:
1. 1 cm splenic aneurysm involving the distal splenic artery. The patient
will be rescheduled for treatment with detachable endovascular coils.