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Peripheral Procedure

  1. Default Peripheral Procedure
    Medical Coding Books
    I was wondering if anyone can help me with this peripheral procedure.

    Abdominal aortogram with runoff, subselective left and right
    renal artery angiograms, selective right superficial femoral
    artery angiogram, left iliac artery angiogram, and Perclose of
    left common femoral artery.


    Peripheral vascular disease, claudication, old myocardial
    infarction, ischemic cardiomyopathy, recurrent claudication.

    After informed consent outlined in detail to the patient of
    risks, benefits, alternatives of endovascular intervention
    including the risks of MI, CVA, bleeding, infection, arrhythmia,
    death, blood transfusion, urgent vascular surgery, and loss of
    limb, the patient is prepped and draped under local anesthesia
    with a Seldinger technique. The left common femoral artery is
    accessed and over a 0.035-inch guidewire, a 6-French 10 cm Cordis
    sheath is placed retrograde in the left common femoral artery. A
    pigtail was then passed retrograde to the level of the abdominal
    aorta and subselective renal angiograms are performed. Nonionic
    contrast, 20 mL DSA power injection. The pigtail is then taken
    to the bifurcation and upon injection 35 mL nonionic contrast
    with runoff down both legs performed. Thereafter, intravenous
    Angiomax Factor 2 inhibitor is commenced and a 6-French flexor 45
    cm sheath is placed contralateral across to the right external
    iliac artery for subselective angiograms of the right leg.
    Utilizing an 0.035 with Glidewire support, the chronic occlusion
    of the right SFA is intervened, however, it is not suitable for
    total cross due to chronic occlusion of at least 40 cm proximal,
    mid, distal, with reconstitution of the right SFA at the adductor
    canal. Perclose of the left common femoral artery is performed
    after removing the sheath with excellent hemostasis. Small Track ooze
    pressure FemoStop placed. The Perclose is performed with
    excellent hemostasis.

    Noted as follows: Normal left and right renal arteries. Mild
    plaque of the distal aorta. Left common iliac artery, external
    and internal arteries, mild plaque, left common femoral artery
    30% lesion noted, diffuse, proximal to mid 60% left SFA stenoses
    noted with chronic occlusion of distal SFA, short 5 cm to 10 cm
    long area of occlusion is noted at the distal SFA with
    reconstitution to the popliteal artery with 3-vessel runoff down
    the left leg. The profunda on the left is large and normal. On
    the right, the right common iliac, external iliac, internal iliac
    patent with mild plaque, right common femoral artery mild plaque,
    patent profunda femoris with flow down in collaterals to the
    occluded right SFA distally, proximal to mid SFA 100% occlusion
    at least 40 cm in length, 3-vessel runoff down infrapopliteal to
    dorsalis pedis, posterior tibial and peroneal vessels of the
    right leg.

    Chronic occlusions of the right proximal mid distal SFA, chronic
    occlusion of left distal SFA with profunda collaterals down both

  2. #2
    I would code 36246-59, 36252, 75716-26 here.

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