Results 1 to 2 of 2

Bilateral Arteriogram

  1. #1
    Question Bilateral Arteriogram
    Exam Training Packages
    I need HELP! coding this!

    PROTOCOL: The patient underwent chemistry evaluation, which revealed a
    creatinine of 4.2. Two weeks ago when the patient was admitted his
    creatinine was 3.7, which was treated to a lower level of 2.0 upon
    discharge on July 1, 2011. Now his creatinine is back up to 4.2. Give
    the need for the procedure we went ahead and proceeded with the
    procedure after discussion with Dr. Bhamani.

    Based on these findings the patient underwent selective imaging without
    the use of bolus chase method and total contrast used was 31 mL of
    Visipaque. The access was obtained via right femoral artery with single
    stick and subsequently J-wire was advanced and 5-French OmniFlush
    catheter was advanced into the left iliac artery using exchange
    glidewire and the catheter tip was placed at the level of the common
    femoral artery. Imaging was obtained at the external iliac artery and
    imaging was obtained with selective small contrast injections. The
    entire extremity on the left side was imaged and on the right side
    imaging of the iliac vessel, femoral, and trifurcation was performed.
    No complications occurred. A probe light was used for cautery device
    and the patient was sent to the recovery room.

    FINDINGS:
    1. The left lower extremity was visualized well and demonstrates the
    external iliac artery shows mild disease.
    2. The left common femoral artery is patent with mild to moderate
    plaque.
    3. The left common femoral artery/superficial femoral artery stent is
    widely patent. This is an IDEV stent with excellent flow through it.
    4. The mid superficial femoral artery percutaneous transluminal
    angioplasty site is widely patent with less than 40% narrowing.
    5. The distal superficial femoral artery/popliteal percutaneous
    transluminal angioplasty site is widely patent. This used to be a
    chronic occlusion, but excellent flow is noted through this vessel and
    flow into the popliteal artery is well preserved.
    6. The trifurcation shows occlusion of the anterior tibial artery, which
    is chronic.
    7. The 50% disease noted in the posterior tibial take off and the
    peroneal artery is a large vessel, which goes all the way to the distal
    foot above the ankle. There is three vessel runoff in the foot with
    posterior tibial/anterior tibial reconstituting above the ankle and the
    peroneal artery.
    8. The right lower extremity was visualized only in the iliac and
    femoral vessels and appears to be intact. There appears to be total
    occlusion of the distal superficial femoral artery, which is chronic and
    the trifurcation is diseased as previously reported.

    Based on these findings the patient has adequate flow and the previous
    stent and percutaneous transluminal angioplasty sites are widely patent.
    Therefore, the patient will continue with wound care as previously and
    followup with his podiatrist. In addition, he will followup with his
    renal physician tomorrow for further recheck and evaluation. The
    patient is advised to continue to encourage fluid PO intake.

  2. #2
    Location
    Birmingham, Alabama
    Posts
    889
    Default
    Quote Originally Posted by amym View Post
    I need HELP! coding this!

    PROTOCOL: The patient underwent chemistry evaluation, which revealed a
    creatinine of 4.2. Two weeks ago when the patient was admitted his
    creatinine was 3.7, which was treated to a lower level of 2.0 upon
    discharge on July 1, 2011. Now his creatinine is back up to 4.2. Give
    the need for the procedure we went ahead and proceeded with the
    procedure after discussion with Dr. Bhamani.

    Based on these findings the patient underwent selective imaging without
    the use of bolus chase method and total contrast used was 31 mL of
    Visipaque. The access was obtained via right femoral artery with single
    stick and subsequently J-wire was advanced and 5-French OmniFlush
    catheter was advanced into the left iliac artery using exchange
    glidewire and the catheter tip was placed at the level of the common
    femoral artery. Imaging was obtained at the external iliac artery and
    imaging was obtained with selective small contrast injections. The
    entire extremity on the left side was imaged and on the right side
    imaging of the iliac vessel, femoral, and trifurcation was performed.
    No complications occurred. A probe light was used for cautery device
    and the patient was sent to the recovery room.

    FINDINGS:
    1. The left lower extremity was visualized well and demonstrates the
    external iliac artery shows mild disease.
    2. The left common femoral artery is patent with mild to moderate
    plaque.
    3. The left common femoral artery/superficial femoral artery stent is
    widely patent. This is an IDEV stent with excellent flow through it.
    4. The mid superficial femoral artery percutaneous transluminal
    angioplasty site is widely patent with less than 40% narrowing.
    5. The distal superficial femoral artery/popliteal percutaneous
    transluminal angioplasty site is widely patent. This used to be a
    chronic occlusion, but excellent flow is noted through this vessel and
    flow into the popliteal artery is well preserved.
    6. The trifurcation shows occlusion of the anterior tibial artery, which
    is chronic.
    7. The 50% disease noted in the posterior tibial take off and the
    peroneal artery is a large vessel, which goes all the way to the distal
    foot above the ankle. There is three vessel runoff in the foot with
    posterior tibial/anterior tibial reconstituting above the ankle and the
    peroneal artery.
    8. The right lower extremity was visualized only in the iliac and
    femoral vessels and appears to be intact. There appears to be total
    occlusion of the distal superficial femoral artery, which is chronic and
    the trifurcation is diseased as previously reported.

    Based on these findings the patient has adequate flow and the previous
    stent and percutaneous transluminal angioplasty sites are widely patent.
    Therefore, the patient will continue with wound care as previously and
    followup with his podiatrist. In addition, he will followup with his
    renal physician tomorrow for further recheck and evaluation. The
    patient is advised to continue to encourage fluid PO intake.
    I see:
    36245
    75716

    HTH
    Danny L. Peoples
    CIRCC,CPC

Similar Threads

  1. Replies: 1
    Last Post: 12-16-2015, 12:40 PM
  2. bilateral Nephrostogram and bilateral nephrostomy tube exchange
    By Misty Dawn in forum Interventional Radiology
    Replies: 1
    Last Post: 11-05-2015, 02:45 PM
  3. Bilateral Carotid Arteriogram femoral approach
    By sheilacpc in forum Interventional Radiology
    Replies: 5
    Last Post: 03-15-2013, 10:46 AM
  4. Bilateral Carotid Arteriogram
    By amym in forum Cardiology
    Replies: 4
    Last Post: 01-27-2012, 01:56 PM
  5. Replies: 0
    Last Post: 05-25-2009, 11:25 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.