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Can someone double check this please??

  1. #1
    Default Can someone double check this please??
    Medical Coding Books
    INDICATIONS:
    Left lower extremity claudication and evidence of severe femoral and external iliac artery stenosis on
    Doppler ultrasound.
    PROCEDURES PERFORMED:
    1. Abdominal flush aortic angiogram.
    2. Fluoroscopy.
    3. Selective cannulation of the left common iliac artery.
    4. Selective left lower extremity runoff angiogram.
    5. Selective right lower extremity runoff angiogram.
    6. Fluoroscopy.
    PROCEDURE:
    After the informed consent was obtained, the patient was brought to the cardiac catheterization laboratory,
    and prepped and draped in usual sterile fashion. The right femoral area was anesthetized with 10 mL of
    0.5% Sensorcaine, and the right femoral artery was cannulated with a 5-French sheath using modified
    Seldinger technique. The 5-French Omni Flush catheter was advanced into the proximal abdominal aorta.
    An abdominal flush angiogram was performed. The catheter was then pulled back and together with a
    Glidewire was advanced into the left iliac artery. The left lower extremity runoff angiogram was then
    performed. The catheter was then withdrawn over a guidewire and the right femoral angiogram runoff was
    performed. The sheath was then pulled and hemostasis was obtained using manual compression. There
    were no complications. Upon completion of the procedure, the patient was transferred to her room in stable
    condition.
    ANATOMY: 1. Abdominal aorta: The abdominal aorta appears to be moderately calcified without evidence of
    aneurysmal dilatation.
    2. Right renal artery: The right renal artery is single and patent.
    3. Left renal artery: The left renal artery is single and patent.
    4. The right common iliac artery is mildly diseased but patent.
    5. The left common iliac artery is mildly diseased but patent.
    6. The right external iliac artery is patent.
    7. The left external iliac artery is totally occluded at the ostium. A large collateral is noted to then
    connected into the distal common femoral artery just prior to bifurcation.
    8. Left lower extremity angiogram: Left lower extremity angiogram demonstrated the occluded
    common femoral artery. The left SFA and profunda were filling via large collateral. The remainder of
    the SFA was widely patent.
    9. Left popliteal artery was patent.
    10. A 2-vessel below-knee runoff was noted. The left anterior tibial artery was subtotally occluded.
    11. Right lower extremity angiogram: Right lower extremity angiogram demonstrated a widely patent
    common femoral artery, SFA, and profunda.
    12. The popliteal artery was patent.
    13. The anterior tibial and posterior tibial arteries were patent. The peroneal artery was totally
    occluded.
    IMPRESSION:
    1. Total occlusion of the left external iliac artery with a large collateral noted.
    2. 2-vessel below-the-knee runoff bilaterally.

    --------------
    36245 -lt
    36245-rt
    75716-26-59
    ???

  2. #2
    Location
    Birmingham, Alabama
    Posts
    889
    Default
    Quote Originally Posted by Worldwalker View Post
    INDICATIONS:
    Left lower extremity claudication and evidence of severe femoral and external iliac artery stenosis on
    Doppler ultrasound.
    PROCEDURES PERFORMED:
    1. Abdominal flush aortic angiogram.
    2. Fluoroscopy.
    3. Selective cannulation of the left common iliac artery.
    4. Selective left lower extremity runoff angiogram.
    5. Selective right lower extremity runoff angiogram.
    6. Fluoroscopy.
    PROCEDURE:
    After the informed consent was obtained, the patient was brought to the cardiac catheterization laboratory,
    and prepped and draped in usual sterile fashion. The right femoral area was anesthetized with 10 mL of
    0.5% Sensorcaine, and the right femoral artery was cannulated with a 5-French sheath using modified
    Seldinger technique. The 5-French Omni Flush catheter was advanced into the proximal abdominal aorta.
    An abdominal flush angiogram was performed. The catheter was then pulled back and together with a
    Glidewire was advanced into the left iliac artery. The left lower extremity runoff angiogram was then
    performed. The catheter was then withdrawn over a guidewire and the right femoral angiogram runoff was
    performed. The sheath was then pulled and hemostasis was obtained using manual compression. There
    were no complications. Upon completion of the procedure, the patient was transferred to her room in stable
    condition.
    ANATOMY: 1. Abdominal aorta: The abdominal aorta appears to be moderately calcified without evidence of
    aneurysmal dilatation.
    2. Right renal artery: The right renal artery is single and patent.
    3. Left renal artery: The left renal artery is single and patent.
    4. The right common iliac artery is mildly diseased but patent.
    5. The left common iliac artery is mildly diseased but patent.
    6. The right external iliac artery is patent.
    7. The left external iliac artery is totally occluded at the ostium. A large collateral is noted to then
    connected into the distal common femoral artery just prior to bifurcation.
    8. Left lower extremity angiogram: Left lower extremity angiogram demonstrated the occluded
    common femoral artery. The left SFA and profunda were filling via large collateral. The remainder of
    the SFA was widely patent.
    9. Left popliteal artery was patent.
    10. A 2-vessel below-knee runoff was noted. The left anterior tibial artery was subtotally occluded.
    11. Right lower extremity angiogram: Right lower extremity angiogram demonstrated a widely patent
    common femoral artery, SFA, and profunda.
    12. The popliteal artery was patent.
    13. The anterior tibial and posterior tibial arteries were patent. The peroneal artery was totally
    occluded.
    IMPRESSION:
    1. Total occlusion of the left external iliac artery with a large collateral noted.
    2. 2-vessel below-the-knee runoff bilaterally.

    --------------
    36245 -lt
    36245-rt
    75716-26-59
    ???
    I would code this way
    36245 LT common iliac
    75716 bilateral extremities
    75625 Aorta (includes views of renals)

    HTH
    Danny L. Peoples
    CIRCC,CPC

  3. #3
    Default
    Quote Originally Posted by dpeoples View Post
    I would code this way
    36245 LT common iliac
    75716 bilateral extremities
    75625 Aorta (includes views of renals)

    HTH
    I agree with Danny!

    Thanks,
    Jim Pawloski, CIRCC

  4. #4
    Default one l ast question..thanks
    75625 is aortograhy by serialography...i'm not sure what serialography is?

  5. #5
    Default
    Why 75625 instead of 75724 ? Thanks for your help!!

  6. #6
    Location
    Birmingham, Alabama
    Posts
    889
    Default
    Quote Originally Posted by Worldwalker View Post
    75625 is aortograhy by serialography...i'm not sure what serialography is?

    laymans answer is mulitple views.

    HTH
    Danny L. Peoples
    CIRCC,CPC

  7. #7
    Default
    You wouldn't use 75724 because the renal arteries weren't SELECTIVELY catheterized. Catheter didn't go into the renal arteries.

    They were imaged by the injection in the abdominal aorta.

    Jessica CPC, CCC

  8. #8
    Default
    Thanks everyone. It's all coming together..

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