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Renal arteriogram

  1. #1
    Question Renal arteriogram
    Medical Coding Books
    I am having some trouble with coding this report, can someone help me?


    HISTORY OF PRESENT ILLNESS: Ms. X is a pleasant woman who has had significant hypertension. She has had a recent cardiac catheterization. She is suspected of having a possible signigicant renal artery stenosis. She is referred for a diagnostic and interventional study to try to evaluate her renal status.

    PROCEDURE NOTE:

    The patient was prepped and draped in the usual manner. The right femoral artery was punctured by the Selinger technique. A 6 French sheath was intorduced in the right femoral artery. Through this sheath, a 6 French LIMA guiding catheter was used to engage the left renal artery. Selective angiogram of the left renal artery was performed. The catheter was also used to do a selective angiogram of the right renal artery.

    After identification of a significant stenosis in the right renal artery, a 0.014 Spartacore wire was advanced across the stenosis in the right renal artery. Over this wire, a 4 mm x 2 cm balloon was used to dilate the lesion. Subsequent to this , a 4.5 mm x 18 mm Genesis stent was positioned across the stenosis and depolyed.

    Closing agiography was performed.

    An angiogram of the right lower extremity was also performed. The catheter was removed at that time.


    *Here are the codes I am using for this report. Can someone please let me know if I am right or if I need to change some things... I am coding in an office for my doc that performed this at the hospital. Thank you to anyone that can offer advice!

    36245-59 x2
    75724-26-59

    35471
    75966-26

    37205
    75960-26

    Brandy Edmondson, CPC

  2. Default
    Quote Originally Posted by brandyleigh23@hotmail.com View Post
    I am having some trouble with coding this report, can someone help me?


    HISTORY OF PRESENT ILLNESS: Ms. X is a pleasant woman who has had significant hypertension. She has had a recent cardiac catheterization. She is suspected of having a possible signigicant renal artery stenosis. She is referred for a diagnostic and interventional study to try to evaluate her renal status.

    PROCEDURE NOTE:

    The patient was prepped and draped in the usual manner. The right femoral artery was punctured by the Selinger technique. A 6 French sheath was intorduced in the right femoral artery. Through this sheath, a 6 French LIMA guiding catheter was used to engage the left renal artery. Selective angiogram of the left renal artery was performed. The catheter was also used to do a selective angiogram of the right renal artery.

    After identification of a significant stenosis in the right renal artery, a 0.014 Spartacore wire was advanced across the stenosis in the right renal artery. Over this wire, a 4 mm x 2 cm balloon was used to dilate the lesion. Subsequent to this , a 4.5 mm x 18 mm Genesis stent was positioned across the stenosis and depolyed.

    Closing agiography was performed.

    An angiogram of the right lower extremity was also performed. The catheter was removed at that time.


    *Here are the codes I am using for this report. Can someone please let me know if I am right or if I need to change some things... I am coding in an office for my doc that performed this at the hospital. Thank you to anyone that can offer advice!

    36245-59 x2
    75724-26-59

    35471
    75966-26

    37205
    75960-26

    Brandy Edmondson, CPC


    Brandy,
    You did ok . But I would not code for the balloon 35471 75966. This would be included in the stent placement. Make sure to add your LT and RT onto your 36245 codes.
    Theresa CCS-P CPMA CCC ICDCT-CM

  3. #3
    Thumbs up
    Thank you Theresa

    I know the stent is a higher valued service vs the angioplasty, but I was confused if this was just for coronary interventions. I've only been doing Cardiology 5 months and I don't quite have everything down pat yet! I looked in the guidelines of the sections I selected my CPT codes from and it did not tell me to include or not include the angio with stent..

    I appreciate you reading the report and your quick response
    I will be sure to add my LT and RT and not include the ballooning.

    Brandy Edmondson, CPC

  4. Default
    Quote Originally Posted by brandyleigh23@hotmail.com View Post
    Thank you Theresa

    I know the stent is a higher valued service vs the angioplasty, but I was confused if this was just for coronary interventions. I've only been doing Cardiology 5 months and I don't quite have everything down pat yet! I looked in the guidelines of the sections I selected my CPT codes from and it did not tell me to include or not include the angio with stent..

    I appreciate you reading the report and your quick response
    I will be sure to add my LT and RT and not include the ballooning.

    Brandy Edmondson, CPC
    Brandy,
    Your welcome. I notice your post here and see you are learning pretty fast. It isn't easy!
    Theresa CCS-P CPMA CCC ICDCT-CM

  5. Default
    If you can get hold of the Z-health Interventional Coding book it is incredible, I use it daily

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