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L1 lumbar artery, L2 lumbar artery, L2 lumbar artery

  1. Default L1 lumbar artery, L2 lumbar artery, L2 lumbar artery
    Medical Coding Books
    Help to code this report

    History: 55-year-old with going right retroperitoneal hematoma
    status-post embolization of the active bleed in the distribution
    of the right renal artery presents with apparent recurrent
    bleeding.

    Procedure and findings: After obtaining informed consent,
    anesthesia was established by the anesthesiologist. Continuous
    physiologic monitoring of arterial blood pressure, pulse and
    oxygen saturation was performed throughout the the procedure.

    The patient was placed supine on the fluoroscopic table and the
    right groin region was prepped and draped in a sterile fashion.
    The right common femoral artery was accessed via Seldinger
    technique, and a 5-French angiographic sheath was placed for
    vascular access. A 5 French SOS selective catheter was used to
    catheterize the right renal artery. Selective angiography with the
    catheter positioned in the origin of the right renal artery
    demonstrated opacification of the upper pole of the right kidney.
    No active extravasation was demonstrated. Using coaxial technique
    a 3 French micro-catheter was advanced into the distal right renal
    artery. Angiography demonstrated no active extravasation in the
    distribution of the terminal branches of the right renal artery in
    the vicinity of the in situ percutaneous nephrostomy where coil
    embolization was performed previously. Subsequently, selective and
    subselective catheterizations of the second renal artery supplying
    the lower pole, T12 intercostal artery, L1 lumbar artery, L2
    lumbar artery, L2 lumbar artery, phrenic artery, capsular artery,
    bilateral internal iliac arteries were performed. No active
    extravasation was demonstrated in the distributions of the above
    arteries. No embolization was performed. The sheath was removed
    followed by manual compression until hemostasis.

    IMPRESSION:

    No active extravasation was demonstrated by subselective
    angiography of the upper pole right renal artery, lower pole renal
    artery, T12 intercostal artery, L1 lumbar artery, L2 lumbar
    artery, L2 lumbar artery, phrenic artery, capsular artery,
    bilateral internal iliac arteries.

    No embolization was performed.

  2. #2
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    Birmingham, Alabama
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    Quote Originally Posted by Shirleybala View Post
    Help to code this report

    History: 55-year-old with going right retroperitoneal hematoma
    status-post embolization of the active bleed in the distribution
    of the right renal artery presents with apparent recurrent
    bleeding.

    Procedure and findings: After obtaining informed consent,
    anesthesia was established by the anesthesiologist. Continuous
    physiologic monitoring of arterial blood pressure, pulse and
    oxygen saturation was performed throughout the the procedure.

    The patient was placed supine on the fluoroscopic table and the
    right groin region was prepped and draped in a sterile fashion.
    The right common femoral artery was accessed via Seldinger
    technique, and a 5-French angiographic sheath was placed for
    vascular access. A 5 French SOS selective catheter was used to
    catheterize the right renal artery. Selective angiography with the
    catheter positioned in the origin of the right renal artery
    demonstrated opacification of the upper pole of the right kidney.
    No active extravasation was demonstrated. Using coaxial technique
    a 3 French micro-catheter was advanced into the distal right renal
    artery. Angiography demonstrated no active extravasation in the
    distribution of the terminal branches of the right renal artery in
    the vicinity of the in situ percutaneous nephrostomy where coil
    embolization was performed previously. Subsequently, selective and
    subselective catheterizations of the second renal artery supplying
    the lower pole, T12 intercostal artery, L1 lumbar artery, L2
    lumbar artery, L2 lumbar artery, phrenic artery, capsular artery,
    bilateral internal iliac arteries were performed. No active
    extravasation was demonstrated in the distributions of the above
    arteries. No embolization was performed. The sheath was removed
    followed by manual compression until hemostasis.

    IMPRESSION:

    No active extravasation was demonstrated by subselective
    angiography of the upper pole right renal artery, lower pole renal
    artery, T12 intercostal artery, L1 lumbar artery, L2 lumbar
    artery, L2 lumbar artery, phrenic artery, capsular artery,
    bilateral internal iliac arteries.

    No embolization was performed.
    The document is a little vague but here goes...

    36215 T12 - 75705
    36246 Lt Internal Iliac - 75736
    36246 Capsular Artery (from Phrenic or Renal)- 75774
    36245 2nd renal - 75774
    36245 Phrenic/Renal (whichever did not lead to capsular)-75724 or 75726
    36245 Rt Internal Iliac - 75736
    36245 L1 - 75705
    36245 L2 - 75705
    36245 L3 - 75705

    Use modifiers 59/76 depending on payor.


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

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