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help with selective angiogram

  1. #1
    Unhappy help with selective angiogram
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    PROCEDURE: Both groins were prepped with Betadine. Using 1% lidocaine, the right common femoral artery wire was placed folowed by a 5-french sheath. Next, a glide wire was placed into the axcending aorta followed by a Pigtail catheter. A 30 cc flush arch aortogram was done. Then, wire was reintroduced, and a JB1 catheter was exchanged. It was then used to intubate the vertebral on the right, handheld injections of about 5 cc of dye or less. When we did the subclavian one, we then measured the pressure in the subclavian the then did a pullback into the innominate artery to show as if there was any gradient with pressure. We hten again placed a glide wire within the catheter and then intubated the left subclavian artery up the vertebral and again did selective shots with multiple views with handheld injection. We then took the catheter out of the left subclavian with the wire involved, and then we were able to intubate the left common carotid artery. Again,multiple views with handheld injections were done with the above findings.

  2. #2
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    Quote Originally Posted by hpgh View Post
    PROCEDURE: Both groins were prepped with Betadine. Using 1% lidocaine, the right common femoral artery wire was placed folowed by a 5-french sheath. Next, a glide wire was placed into the axcending aorta followed by a Pigtail catheter. A 30 cc flush arch aortogram was done. Then, wire was reintroduced, and a JB1 catheter was exchanged. It was then used to intubate the vertebral on the right, handheld injections of about 5 cc of dye or less. When we did the subclavian one, we then measured the pressure in the subclavian the then did a pullback into the innominate artery to show as if there was any gradient with pressure. We hten again placed a glide wire within the catheter and then intubated the left subclavian artery up the vertebral and again did selective shots with multiple views with handheld injection. We then took the catheter out of the left subclavian with the wire involved, and then we were able to intubate the left common carotid artery. Again,multiple views with handheld injections were done with the above findings.

    Did he document findings? Without that information this is impossible to code accurately, but here is what I see:

    36217 for Rt Vertebral
    36216 (59) for Lt Vertebral
    36215 (59) for Lt Common Carotid

    The possible Imaging codes are:
    75650 for the arch
    75685 Rt Vertebral
    75685 Lt Vertebral
    75676 Lt Common Carotid

    It is not enough to say he performed the films/injections, he must give an interpretation to meet the criteria neccesary to code these procedures.

    HTH
    Danny L. Peoples
    CIRCC,CPC

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