Wiki Which type of catheter?

[jdibble]

My cardiologists do PCI's in the cath lab and use a system to document their procedures which is very lacking in completeness and I feel does not document fully or correctly the procedures they say the have performed. I could use some help in distinguishing if a procedure was done?

One cardiologist states that he did a thrombectomy with stent placement in the right coronary artery, which is listed under a heading called: "Impressions and Recommendations". In the portion of the note where the procedure note is located, there is no mention of the thrombectomy. When I queried the assistant in the cath lab for clarification (note that I am not allowed to question the doctor - communication has to go through this assistant!) it was relayed to me that he "included the pronto catheter that was used for the thrombectomy part of his procedure in the narrative." However, in the note, under the "narrative" section, there is only the description of the diagnostic cath procedure performed and no mention of a Pronto cath. Under the section for the PCI performed, there is one line that states: A 6 FR Convey JR4 guiding catheter was used to intubate the vessel. The rest of the note documents a stent placement and a balloon angioplasty.

Is this documentation of a thrombectomy? Can someone tell me if a Pronto cath and a Convey are the same or different? From my research on line I don't see them being the same, but would a "intubated vessel" through a Convey cath be a thrombectomy? I don't think so, but I just need some verification before I go back to this "assistant" and ask her to prove where the documentation is supposed to be!!

Thanks for any help I can get!!!

 

[Jim Pawloski]

My cardiologists do PCI's in the cath lab and use a system to document their procedures which is very lacking in completeness and I feel does not document fully or correctly the procedures they say the have performed. I could use some help in distinguishing if a procedure was done?

One cardiologist states that he did a thrombectomy with stent placement in the right coronary artery, which is listed under a heading called: "Impressions and Recommendations". In the portion of the note where the procedure note is located, there is no mention of the thrombectomy. When I queried the assistant in the cath lab for clarification (note that I am not allowed to question the doctor - communication has to go through this assistant!) it was relayed to me that he "included the pronto catheter that was used for the thrombectomy part of his procedure in the narrative." However, in the note, under the "narrative" section, there is only the description of the diagnostic cath procedure performed and no mention of a Pronto cath. Under the section for the PCI performed, there is one line that states: A 6 FR Convey JR4 guiding catheter was used to intubate the vessel. The rest of the note documents a stent placement and a balloon angioplasty.

Is this documentation of a thrombectomy? Can someone tell me if a Pronto cath and a Convey are the same or different? From my research on line I don't see them being the same, but would a "intubated vessel" through a Convey cath be a thrombectomy? I don't think so, but I just need some verification before I go back to this "assistant" and ask her to prove where the documentation is supposed to be!!

Thanks for any help I can get!!!

Hi Jodi,
A Pronto catheter is used for suction thrombectomy. That is only billable when the patient is having an documented MI, and is part of the C9606 or 92941 codes. The thrombectomy code is for mechanical thrombectomy which must be done with a Angio-jet catheter. The Convey catheter is just a guiding catheter in which an interventional procedure is performed through.
Good luck,
Jim Pawloski, CIRCC

 

[jdibble]

Hi Jodi,
A Pronto catheter is used for suction thrombectomy. That is only billable when the patient is having an documented MI, and is part of the C9606 or 92941 codes. The thrombectomy code is for mechanical thrombectomy which must be done with a Angio-jet catheter. The Convey catheter is just a guiding catheter in which an interventional procedure is performed through.
Good luck,
Jim Pawloski, CIRCC

Thanks Jim. That is what I thought - that they were 2 different catheters, but I just wanted to be sure before I went back to this assistant because she is always fighting me about what she thinks has been documented, when I tell her it has not! The issue was that there was no thrombectomy documented in the procedure note - only in the impression section. So I quiered what type of thrombectomy was done to be sure I wasn't missing a charge for a mechanical one as I knew the suction thrombectomy was not billable. Their response to me was that he had documented the Pronto catheter - but there is no documentation anywhere for even that!!

Thanks again for your help!