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uterine artery cath placement

  1. Default uterine artery cath placement
    Medical Coding Books
    Can anyone get me the possible codes for the below procedure???????


    42-year-old G2P1001 35 weeks 6-day gravid female
    with placenta previa and possible placenta accreta. Patient
    referred for bilateral uterine artery catheter placement prior to
    cesarean section


    The bilateral groins were prepped and draped in the usual sterile
    fashion.

    After the administration of local anesthesia and under ultrasound
    guidance, access into the right common femoral artery was obtained
    a 21-gauge micropuncture set. A Bentson wire was placed through
    the transition dilator and advanced centrally into the abdominal
    aorta. The transition dilator was then exchanged for a 5-French
    vascular sheath.

    After the administration of local anesthesia and under ultrasound
    guidance, access into the left common femoral artery was obtained
    a 21-gauge micropuncture set. A Bentson wire was placed through
    the transition dilator and advanced centrally into the abdominal
    aorta. The transition dilator was then exchanged for a 5-French
    vascular sheath.

    A 4-French glide Berenstein catheter was then advanced over the
    wire and through the right common femoral artery sheath and
    positioned within the abdominal aorta. The catheter and wire were
    then used to select the contralateral left common femoral artery.
    The Bentson wire was then exchanged for a Glidewire and the
    catheter and glide wire were used to select the left internal
    iliac artery.

    A gentle injection of contrast confirmed good positioning within
    the left internal iliac artery and identified the origin of the
    left uterine artery. Using roadmap technique, the catheter and
    Glidewire were used to select the left uterine artery. The
    catheter was advanced over the wire and positioned within the mid
    left uterine artery. A gentle injection of contrast confirmed
    good positioning of the distal tip of the catheter within the mid
    left uterine artery.

    A 4-French glide Berenstein catheter was then advanced over the
    wire and through the left common femoral artery sheath and
    positioned within the abdominal aorta. The catheter and wire were
    then used to select the contralateral right common femoral artery.
    The Bentson wire was then exchanged for a Glidewire and the
    catheter and glide wire were used to select the right internal
    iliac artery.

    A gentle injection of contrast confirmed good positioning within
    the right internal iliac artery and identified the origin of the
    right uterine artery. Using roadmap technique, the catheter and
    Glidewire were used to select the right uterine artery. The
    catheter was advanced over the wire and positioned within the mid
    right uterine artery. A gentle injection of contrast confirmed
    good positioning of the distal tip of the catheter within the mid
    right uterine artery.

    The catheters and sheaths were attached secured to the skin with
    20 Prolene suture and attached to pressure flush bags. Sterile
    dressings were then applied over the skin entry sites.

    Impression:
    Bilateral uterine artery catheterizations as described above.
    Prabha CPC

  2. #2
    Default Contributor
    36247, 36247-59, 75736, 75736-59.
    Side Mod-RT & LT also valid with procedure codes.
    It helps you.

    Quote Originally Posted by prabha View Post
    Can anyone get me the possible codes for the below procedure???????


    42-year-old G2P1001 35 weeks 6-day gravid female
    with placenta previa and possible placenta accreta. Patient
    referred for bilateral uterine artery catheter placement prior to
    cesarean section


    The bilateral groins were prepped and draped in the usual sterile
    fashion.

    After the administration of local anesthesia and under ultrasound
    guidance, access into the right common femoral artery was obtained
    a 21-gauge micropuncture set. A Bentson wire was placed through
    the transition dilator and advanced centrally into the abdominal
    aorta. The transition dilator was then exchanged for a 5-French
    vascular sheath.

    After the administration of local anesthesia and under ultrasound
    guidance, access into the left common femoral artery was obtained
    a 21-gauge micropuncture set. A Bentson wire was placed through
    the transition dilator and advanced centrally into the abdominal
    aorta. The transition dilator was then exchanged for a 5-French
    vascular sheath.

    A 4-French glide Berenstein catheter was then advanced over the
    wire and through the right common femoral artery sheath and
    positioned within the abdominal aorta. The catheter and wire were
    then used to select the contralateral left common femoral artery.
    The Bentson wire was then exchanged for a Glidewire and the
    catheter and glide wire were used to select the left internal
    iliac artery.

    A gentle injection of contrast confirmed good positioning within
    the left internal iliac artery and identified the origin of the
    left uterine artery. Using roadmap technique, the catheter and
    Glidewire were used to select the left uterine artery. The
    catheter was advanced over the wire and positioned within the mid
    left uterine artery. A gentle injection of contrast confirmed
    good positioning of the distal tip of the catheter within the mid
    left uterine artery.

    A 4-French glide Berenstein catheter was then advanced over the
    wire and through the left common femoral artery sheath and
    positioned within the abdominal aorta. The catheter and wire were
    then used to select the contralateral right common femoral artery.
    The Bentson wire was then exchanged for a Glidewire and the
    catheter and glide wire were used to select the right internal
    iliac artery.

    A gentle injection of contrast confirmed good positioning within
    the right internal iliac artery and identified the origin of the
    right uterine artery. Using roadmap technique, the catheter and
    Glidewire were used to select the right uterine artery. The
    catheter was advanced over the wire and positioned within the mid
    right uterine artery. A gentle injection of contrast confirmed
    good positioning of the distal tip of the catheter within the mid
    right uterine artery.

    The catheters and sheaths were attached secured to the skin with
    20 Prolene suture and attached to pressure flush bags. Sterile
    dressings were then applied over the skin entry sites.

    Impression:
    Bilateral uterine artery catheterizations as described above.

  3. #3
    Default
    Quote Originally Posted by prabha View Post
    Can anyone get me the possible codes for the below procedure???????


    42-year-old G2P1001 35 weeks 6-day gravid female
    with placenta previa and possible placenta accreta. Patient
    referred for bilateral uterine artery catheter placement prior to
    cesarean section


    The bilateral groins were prepped and draped in the usual sterile
    fashion.

    After the administration of local anesthesia and under ultrasound
    guidance, access into the right common femoral artery was obtained
    a 21-gauge micropuncture set. A Bentson wire was placed through
    the transition dilator and advanced centrally into the abdominal
    aorta. The transition dilator was then exchanged for a 5-French
    vascular sheath.

    After the administration of local anesthesia and under ultrasound
    guidance, access into the left common femoral artery was obtained
    a 21-gauge micropuncture set. A Bentson wire was placed through
    the transition dilator and advanced centrally into the abdominal
    aorta. The transition dilator was then exchanged for a 5-French
    vascular sheath.

    A 4-French glide Berenstein catheter was then advanced over the
    wire and through the right common femoral artery sheath and
    positioned within the abdominal aorta. The catheter and wire were
    then used to select the contralateral left common femoral artery.
    The Bentson wire was then exchanged for a Glidewire and the
    catheter and glide wire were used to select the left internal
    iliac artery.

    A gentle injection of contrast confirmed good positioning within
    the left internal iliac artery and identified the origin of the
    left uterine artery. Using roadmap technique, the catheter and
    Glidewire were used to select the left uterine artery. The
    catheter was advanced over the wire and positioned within the mid
    left uterine artery. A gentle injection of contrast confirmed
    good positioning of the distal tip of the catheter within the mid
    left uterine artery.

    A 4-French glide Berenstein catheter was then advanced over the
    wire and through the left common femoral artery sheath and
    positioned within the abdominal aorta. The catheter and wire were
    then used to select the contralateral right common femoral artery.
    The Bentson wire was then exchanged for a Glidewire and the
    catheter and glide wire were used to select the right internal
    iliac artery.

    A gentle injection of contrast confirmed good positioning within
    the right internal iliac artery and identified the origin of the
    right uterine artery. Using roadmap technique, the catheter and
    Glidewire were used to select the right uterine artery. The
    catheter was advanced over the wire and positioned within the mid
    right uterine artery. A gentle injection of contrast confirmed
    good positioning of the distal tip of the catheter within the mid
    right uterine artery.

    The catheters and sheaths were attached secured to the skin with
    20 Prolene suture and attached to pressure flush bags. Sterile
    dressings were then applied over the skin entry sites.

    Impression:
    Bilateral uterine artery catheterizations as described above.
    I would prefer 36247, 36247-59 only. IMO there is no diagnostic angiography performed hence 75736 not applicable.


    Thanks,
    Abdul Saleem CPC

  4. Default
    I agree with HNISHA and drspatil the codes 36247 LT 36247 RT but for -59 -documentation should support different session, different site or organ system................. .What if I append -51 as appropriate rather than -59
    I need your validation please. Imay be wrong but I want to know why am I wrong?

  5. #5
    Default
    Based on the Insurance we can use either RT LT or 59 modifiers.

    With reference to 51, 59 modifiers
    (51-Multiple procedure
    59-Distinct procedural service)

    IMO the procedures performed here are similar but different anatomical sites. Hence we have appended 59 modifier.

    Hope this make sense....

    Thanks,
    Abdul Saleem CPC

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