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Bilateral Carotid Arteriogram femoral approach

  1. #1
    Default Bilateral Carotid Arteriogram femoral approach
    Medical Coding Books
    Hello,

    Please help with this one...

    The patient had an aortic arch aortogram and a bilateral carotid arteriogram done.

    The catheter reached the aorta via the femoral approach and an aortic arteriogram was done.

    Catheter was further selected into the right common carotid artery and then to the left common carotid artery...

    What codes would you use?

    Thank you,

    Sheila

  2. #2
    Location
    Birmingham, Alabama
    Posts
    890
    Default
    Quote Originally Posted by sheilacpc View Post
    Hello,

    Please help with this one...

    The patient had an aortic arch aortogram and a bilateral carotid arteriogram done.

    The catheter reached the aorta via the femoral approach and an aortic arteriogram was done.

    Catheter was further selected into the right common carotid artery and then to the left common carotid artery...

    What codes would you use?

    Thank you,

    Sheila

    I see these:
    36216
    36215-59

    (75650, 75671, 75680 depends on the findings which are not documented)

    I hope this helps.
    Danny L. Peoples
    CIRCC,CPC

  3. #3
    Default
    I agree with the above assuming it's not a bovine arch

  4. #4
    Default 2013 Arch aortogram w view of bilateral carotids
    A percutaneous puncture of the right groin was done under ultrasound
    guidance. A sheath and guidewire were passed. The guidewire was passed up
    into the arch of the aorta followed by the soft view Omni flush catheter.
    The catheter was parked just above the aortic valve and a contrast injection
    was done. This maneuver allowed us to visualize the aortic arch and the
    three branches of the aortic arch. The brachiocephalic vessel appeared to be
    widely patent with good flow into the right subclavian and the right common
    carotid. The carotid bifurcation on the right was significantly diseased
    with an approximate 80-85% stenosis of the internal carotid artery right at
    the bifurcation. The artery beyond the stenosis appeared to be of a normal
    caliber for the internal carotid artery.

    The left common carotid takeoff was visualized and was widely patent. At the
    bifurcation on the left side, there was also apparent disease although not
    quite as significant as that on the right side. I would judge the area of
    stenosis on the left to be approximately 60-70% stenosis. The left
    subclavian artery was widely patent and good flow down to the left arm.

    How would you code this for 2013?
    Thank you!

  5. #5
    Location
    Birmingham, Alabama
    Posts
    890
    Default
    Quote Originally Posted by endrest View Post
    a percutaneous puncture of the right groin was done under ultrasound
    guidance. A sheath and guidewire were passed. The guidewire was passed up
    into the arch of the aorta followed by the soft view omni flush catheter.
    The catheter was parked just above the aortic valve and a contrast injection
    was done. This maneuver allowed us to visualize the aortic arch and the
    three branches of the aortic arch. The brachiocephalic vessel appeared to be
    widely patent with good flow into the right subclavian and the right common
    carotid. The carotid bifurcation on the right was significantly diseased
    with an approximate 80-85% stenosis of the internal carotid artery right at
    the bifurcation. The artery beyond the stenosis appeared to be of a normal
    caliber for the internal carotid artery.

    The left common carotid takeoff was visualized and was widely patent. At the
    bifurcation on the left side, there was also apparent disease although not
    quite as significant as that on the right side. I would judge the area of
    stenosis on the left to be approximately 60-70% stenosis. The left
    subclavian artery was widely patent and good flow down to the left arm.

    How would you code this for 2013?
    Thank you!
    36221

    hth
    Danny L. Peoples
    CIRCC,CPC

  6. #6
    Default
    Thank you hth!! (I had that but was doubting myself and looking at 36200 + S&I)

    Tammy

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