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Aortic Stent Graft for AAA-HELP

  1. #1
    Default Aortic Stent Graft for AAA-HELP
    Exam Training Packages
    These still have me so confused. Please look at this one too and tell me what you think? I have these codes but i'm second guessing myself. I'm just still not comfortable with these.. Thanks again!!!!

    75952 26
    and then i get lost...?????

    Aortic stent graft for treatment of aortic aneurysm
    An 8-French sheath was placed in the right femoral artery
    percutaneously for access. The left groin cutdown was made using
    a transverse suprainguinal crease incision. Common femoral
    artery was dissected out and looped for vascular control. A
    guidewire was passed up the right femoral artery into the aortic
    arch area. An 18-gauge needle was used to access the exposed
    left femoral artery and a guidewire likewise positioned up the
    thoracic aorta.

    Next a snare was placed up the right femoral sheath. Following
    this the 17-French AFX sheath was placed up the left femoral
    artery replacing it for the previously placed 6-French sheath.
    This was done and the contralateral limb wire was passed up the
    17-French sheath, snared with a snare, and brought out the right

    femoral sheath. Once we had these under control. The AFX
    bifurcated device was transferred to the AFX sheath and advanced
    under fluoroscopy to the distal end to well above the aortic
    bifurcation releasing the limb to the graft. We then pulled the

    entire system down the aortic bifurcation. At that point we then
    advanced the 0.014 Endologix guidewire up the contralateral limb
    wire hypotube. Once this was done the main body of the graft was
    deployed by pulling the control cord handle.

    At this point retracted the AFX sheet deploying the ipsilateral
    limb. We then removed the inner core assembly and advanced the
    dilator into the AFX sheet. We then advanced the dilator and
    sheath assembly to just above the level of the lowest renal

    At this point we released the contralateral limb by retracting
    the SurePass wire and pulling the limb cover from the limb. We
    then passed up a pigtail catheter up over the 0.014 wire and
    placed at just above the renal arteries.

    At this point arteriogram was done to visualize the areas of the
    renals. These were marked and a C-arm fixed.

    Once this was done we advanced the infra- and suprarenal aortic
    cuff above the renal arteries. We then removed the safety clip
    and began deployment deploying two segments. We then pulled the
    whole assembly back to place the highest point of the aortic cuff
    graft just at the lower edge of the left renal artery, which was
    about a centimeter distal from the right renal artery. Once we
    had this in place deployment was completed. We then pulled back
    the pigtail catheter and advanced up the center of the graft
    through the aortic cuff. Arteriogram was done at this point
    showing no visible endoleaks and good placement of the graft.
    Because the deployment was made complete the decision was made to
    forego any balloon dilatation.

    Once we had accomplished this the device was removed from the
    left femoral artery and clamps applied. The artery was repaired
    using interrupted 6-0 Prolene sutures. Clamps released and good
    pulse felt beyond repair. The right 8-French sheath was removed

    using a Mynx closure device. This worked well without any

  2. #2
    Alexandria, LA
    75952 26
    and then i get lost...?????
    Code 36812 only once, there was no cut-down on the right side, only the left.
    Your other codes are correct, but also add 34825 and 75953 for the aortic cuff.
    Everything else is included.

  3. #3
    Thank you soo much for your help!! These are so complicated for me.. ugghhh...

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