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Thread: Peripheral coding (Question)

  1. #1
    Join Date
    Apr 2007

    Default Peripheral coding (Question)

    AAPC: Back to School
    Is there pherpherial coders out there?

    I'd like your input on this, thanks.

    CPT 35474
    CPT 35474.59 I selected this because it looks like two distinct lesion addressed in the
    CPT 36247.51
    CPT 75630.26
    CPT 75962.26

    1)Selective 4th order angiogram of the right superficial femoral artery via a contralateral approach.
    2)Baloon angioplasty of the distal superficial femoral artery on the right.
    3)Baloon angioplasty of the popliteal artery on the right.

    The soft tissues of the left groin were infiltrated with a 1% lidocaine solution for local anesthesia. Using the modified Seldinger technigque, with a single stick to the anterior wall of the femoral artery, a 5-French arterial sheath was inserted and flushed without difficulty. A 5-French catheter with a Terumo Advantage wire was then used to obtain access into the right common iliac artery. The wire was then manipulated into the right superficial femoral artery. The Omni Flush catheter was then pulled back and removed over the wire. The 5 French sheath was then pulled back and removed. We then went up with a 6-French Destination sheath. This was taken up over the wire under fluoroscopic guidance and placed into the right superficial femoral artery. A selective right superficial femoral artery angiogram was done at the site of the know lesion. The Terumo wire was then manipulated through the catheter, across the lesion in question, and then placed distally within the peroneal artery. We then went up a 4 x 40 balloon. This was paid across the lesion in question. Dilatation was then done to 10 atomospheres for a total of 70 seconds. The balloon was then pushed forward to the popliteal lesion where dilatation was done to 10 atmospheres for a total of 1 minute. The balloon was then pulled back and removed. Multiple angiographic views were then taken and recorded. The wire was then pulled back and removed. Final angiographic views were taken. The Destination sheath was then pulled back and exchanged for a 7-French sheath, given that there was some mild oozing around the sheath. At the conclusion of the case an ACT was drawn as the patient was given 4000 units of heparin at the beginning of the case. The patient was sent to the prep recovery room in stable condition with stable vital signs.

    Last edited by daniel; 10-18-2010 at 04:15 PM.

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