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Renal arterial procedure

  1. Default Renal arterial procedure
    Medical Coding Books
    Can anyone help me with the below procedure??

    the supine position and both groins prepped and draped in sterile
    fashion.
    The skin was anesthetized with 1% lidocaine.
    A micropuncture needle was used to access the left common femoral artery.
    Using Seldinger technique, a 5 French vascular sheath was placed. Via the
    sheath, a 5 French pigtail catheter was placed to the level of the
    abdominal aorta and an abdominal aortogram was performed with attention
    to the renal arteries.
    Single bilateral renal arteries were identified.
    Each of the renal arteries was selectively catheterized with a 5 French
    Simmons I Glide catheter. Pressure measurements were obtained. These
    revealed no gradients. There was no evidence of osteal nor proximal
    stenosis and the lack of pressure gradient further confirmed the
    angiographic findings.
    The right kidney measures approximately one-half the craniocaudal length
    of the left kidney.
    Given the discrepancy in the renal parenchyma, request had been made as
    part of the consultation of this patient for renal vein renin sampling.
    The right common femoral vein was punctured with a micropuncture needle
    under ultrasound guidance. Using Seldinger technique, a 5 French vascular
    sheath was placed. Via the sheath, a 5 French pigtail catheter was placed
    both below and above the renal veins and inferior vena cava venous sample
    obtained for renin levels.
    The 5 French Simmons I Glide catheter was used to selectively catheterize
    each of the renal veins and, again, selective renal vein renin sampling
    was obtained. Following the procedure, the catheter and sheath were
    removed from both the right groin and left groin and pressure applied for
    10 minutes. There was no postprocedural hematoma, nor change in the
    distal vascular examination. The patient tolerated the procedure well and
    was transported to his room in stable condition.
    FINDINGS:
    There is no evidence of stenosis involving either renal artery. The right
    kidney is much more atrophied than the left and selective renal vein
    renin sampling was sent for further analysis.
    Prabha CPC

  2. Thumbs up
    Hi Prabha,

    You can use these code

    36245, 36245-59
    75724-26
    36011, 36011-59
    75833-26, 59


    Thanks,

    Vikas Maheshwari
    MBA-HCS, CPC-H
    Last edited by vikas.maheshwari; 07-15-2009 at 05:33 AM.

  3. #3
    Default
    I agree with the codes, except for modifier 26, I don't believe it can be used in this manner, check your provider. Also the code for venous sampling s&i is 75893 x 2

  4. #4
    Location
    Birmingham, Alabama
    Posts
    889
    Default
    Quote Originally Posted by prabha View Post
    Can anyone help me with the below procedure??

    the supine position and both groins prepped and draped in sterile
    fashion.
    The skin was anesthetized with 1% lidocaine.
    A micropuncture needle was used to access the left common femoral artery.
    Using Seldinger technique, a 5 French vascular sheath was placed. Via the
    sheath, a 5 French pigtail catheter was placed to the level of the
    abdominal aorta and an abdominal aortogram was performed with attention
    to the renal arteries.
    Single bilateral renal arteries were identified.
    Each of the renal arteries was selectively catheterized with a 5 French
    Simmons I Glide catheter. Pressure measurements were obtained. These
    revealed no gradients. There was no evidence of osteal nor proximal
    stenosis and the lack of pressure gradient further confirmed the
    angiographic findings.
    The right kidney measures approximately one-half the craniocaudal length
    of the left kidney.
    Given the discrepancy in the renal parenchyma, request had been made as
    part of the consultation of this patient for renal vein renin sampling.
    The right common femoral vein was punctured with a micropuncture needle
    under ultrasound guidance. Using Seldinger technique, a 5 French vascular
    sheath was placed. Via the sheath, a 5 French pigtail catheter was placed
    both below and above the renal veins and inferior vena cava venous sample
    obtained for renin levels.
    The 5 French Simmons I Glide catheter was used to selectively catheterize
    each of the renal veins and, again, selective renal vein renin sampling
    was obtained. Following the procedure, the catheter and sheath were
    removed from both the right groin and left groin and pressure applied for
    10 minutes. There was no postprocedural hematoma, nor change in the
    distal vascular examination. The patient tolerated the procedure well and
    was transported to his room in stable condition.
    FINDINGS:
    There is no evidence of stenosis involving either renal artery. The right
    kidney is much more atrophied than the left and selective renal vein
    renin sampling was sent for further analysis.

    for diagnostic renal angiography
    36245 (x2) modify per payor
    75724
    for venous sampling
    36500 (x2) includes catheter placement
    75893 (x2) includes diagnostic venography

    apply modifier 26 to the 7000 series codes if the charges are for professional component (not facility) only.

    HTH
    Last edited by dpeoples; 07-15-2009 at 03:31 PM.
    Danny L. Peoples
    CIRCC,CPC

  5. Default
    Thanks for all replies.....
    Prabha CPC

  6. #6
    Default
    I also came up with
    75724
    36245x2
    75893x2
    36500x2

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