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Am I missing something here?

  1. Default Am I missing something here?
    Medical Coding Books
    Is there documentation here for cath placement?

    Procedure:
    The patient was brought to the cath lab and placed on the table. The patient was prepped and draped in sterile fashion. Access was obtained via the right femoral artery via modified Seldinger technique after 1% lidocaine was used to anesthetize the area. A 5-french sheath was placed in the right femoral artery. There was a 4-french venous access that was obtained as well as no peripheral access was available. Used a 5-french rim catheter to cross over and selective angiogram shots of the right lower extremity were taken. We as well took selective shots of the left lower extremity through the sheath. The patient tolerated the procedure well. There were no complications. Sheath was held and manual pressure was used to obtain hemostasis.

    Findings:
    1. The right lower extremity shows a 40% lesion. The common femoral artery has a 40% lesion just proximal to the graft, the graft is patent and popliteal is patent. There is two0vessel runoff below the leg.

    2. In the left lower extremity there is no significant disease in the external iliac or the common femoral artery. There is a patent graft on the left. There is a kink at the distal anastomosis. The popliteal is patent. There is two-vessel runoff below the knee.

  2. Default
    what about codes 36005 and 75716

  3. #3
    Location
    Chennai,Tamilnadu
    Posts
    95
    Smile
    As the other person given is venous puncture code(36005) and arteriogram(75716) its not perfect.
    MY THOUGHTS
    I think their should be query on catheter placement on contralateral side.as the artery is not mentioned i think we can go with
    36245-FIRST OREDER CATHETER PLACEMENT
    75716-BILATERAL ANGIOS
    or 36200
    75716 if angiograms were performed by plasement of catheter in aorta

  4. #4
    Location
    Birmingham, Alabama
    Posts
    889
    Default
    Quote Originally Posted by AshleyMartin View Post
    Is there documentation here for cath placement?

    Procedure:
    The patient was brought to the cath lab and placed on the table. The patient was prepped and draped in sterile fashion. [I]Access was obtained via the right femoral artery [/I]via modified Seldinger technique after 1% lidocaine was used to anesthetize the area. A 5-french sheath was placed in the right femoral artery. There was a 4-french venous access that was obtained as well as no peripheral access was available. Used a 5-french rim catheter to cross over and selective angiogram shots of the right lower extremity were taken. We as well took selective shots of the left lower extremity through the sheath. The patient tolerated the procedure well. There were no complications. Sheath was held and manual pressure was used to obtain hemostasis.

    Findings:
    1. The right lower extremity shows a 40% lesion. The common femoral artery has a 40% lesion just proximal to the graft, the graft is patent and popliteal is patent. There is two0vessel runoff below the leg.

    2. In the left lower extremity there is no significant disease in the external iliac or the common femoral artery. There is a patent graft on the left. There is a kink at the distal anastomosis. The popliteal is patent. There is two-vessel runoff below the knee.


    hmmm.....
    There are RT vs Left incongruities (in bold italics) within the procedural description. I would try to clarify access site and specific artery selected at/after crossover (aortic bifurcation?). Otherwise all you really have documented is:
    75716 for bilateral arteriogram of lower extremities
    36140 for catheter placement (lower extremity artery access) from which a bilateral study is impossible outside of some type of bypass (fem-fem, iliac etc)
    and 36000 for venous acess (no contrast injection/venographies)

    HTH
    Danny L. Peoples
    CIRCC,CPC

  5. #5
    Default
    I was thinking along those same lines Danny.

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