This is a first case for me.
So would I just code this with CPT 33968 w/mod 52.
And can I code for the aortagram in this case?
Indications for Procedurue:
The pt had intra-aortic ballon pump placement for cardiogenic shock. The nurse noted that there was blood in the lumen to the ballon pump and the balloon pump stopped working. Removal of the intra-aortic balloon pump was unsuccessful. It was decided to bring the pt down to the cath lab to remove teh balloon under fluorscopic guidance.
The pt was draped in the usual steril fashion. A 0.014 inch wire was inserted into the intra-aortic balloon, but under fluoroscpic guidance, it showed that the balloon would not come back distally. It hung up at the iliac artery. Subsequently, this was changed for a 0.018 inch wire. Upon review, it was noted that the balloon pump was not stuck to tortuosity and it is probably due to the ballon not rewrapping completely upon defaltion. Attempt was made to hook this up to the balloon pump apparatus to re-inlfate and defalte. This was not successful. An aorotgram was done, which showd that the ballon is not befated completely. There was no dissection in the aorta noted.
The balloon pump was pulled back but the balloon pump had difficulty going into the sheth. Possiblity of up-sizing the sheath was consider, but this would mean that we would have to cut the ballon pump. It was decieded to call the vascular surgeon to futrher assess and consult on the problem.
Intra-aortic balloon pump that has not defalted or rewrapped complete.
Yes, I would also code 33968-52 and 75605.
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