Hi all,
How would you code the following scenraio:
ABDOMINAL AORTOGRAM, US GUIDE VASCULAR ACCESS, THROMBOLYSIS, FLUORO GUIDE INSERTION VEIN, US GUIDE -
CLINICALINDICATION: The patient presents with a history of chronic ischemia of the right lower extremity with acute worsening.
FINDINGS:
Following normal sterile protocol and using ultrasound guidance, the thrombose limb of the right iliac graft was localized. Following needle placement and then guide wire placement a 6 French sheath was inserted. The guide wire was then introduced all the way to the aortic bifurcation. Contrast injection reveals acute cut off the right iliac graft. Next this reveals minimal fillin of the common iliac artery due to acute thrombus. Next the catheter was exchanged for an infusion catheter which was placed in the external iliac artery. An infusion wire was then placed covering the remainder of the iliac artery just into the aortic bifurcation TPA was given in a bolus of approximately 2,000,000 units with an overnight infusion of approximately .5 mL/hour. The patient is also systemically heparinized. Follow-up angiogram is to be obtained in the a.m.
IMPRESSION:
Initiation of thrombolytic therapy in the thrombosed right-sided limb of an aorta by femoral graft. Thrombolytic therapy is to be administered over the evening and a follow-up angiogram is to be obtained in the a.m. The patient tolerated the procedure well without evidence of immediate complication.
I ended up in choosing 75625,76937,37201,75896.
I am confused in the following areas:
1.Since the infused catheter in the external iliac do we need to code for the selective vessel,if so which order needs to be coded.
2.we cannot code for F/u angiogram since it states "is to be obtained in the a.m."
Any help in this regard would be greatly appreciated!!!!!!!!!
Barbie
How would you code the following scenraio:
ABDOMINAL AORTOGRAM, US GUIDE VASCULAR ACCESS, THROMBOLYSIS, FLUORO GUIDE INSERTION VEIN, US GUIDE -
CLINICALINDICATION: The patient presents with a history of chronic ischemia of the right lower extremity with acute worsening.
FINDINGS:
Following normal sterile protocol and using ultrasound guidance, the thrombose limb of the right iliac graft was localized. Following needle placement and then guide wire placement a 6 French sheath was inserted. The guide wire was then introduced all the way to the aortic bifurcation. Contrast injection reveals acute cut off the right iliac graft. Next this reveals minimal fillin of the common iliac artery due to acute thrombus. Next the catheter was exchanged for an infusion catheter which was placed in the external iliac artery. An infusion wire was then placed covering the remainder of the iliac artery just into the aortic bifurcation TPA was given in a bolus of approximately 2,000,000 units with an overnight infusion of approximately .5 mL/hour. The patient is also systemically heparinized. Follow-up angiogram is to be obtained in the a.m.
IMPRESSION:
Initiation of thrombolytic therapy in the thrombosed right-sided limb of an aorta by femoral graft. Thrombolytic therapy is to be administered over the evening and a follow-up angiogram is to be obtained in the a.m. The patient tolerated the procedure well without evidence of immediate complication.
I ended up in choosing 75625,76937,37201,75896.
I am confused in the following areas:
1.Since the infused catheter in the external iliac do we need to code for the selective vessel,if so which order needs to be coded.
2.we cannot code for F/u angiogram since it states "is to be obtained in the a.m."
Any help in this regard would be greatly appreciated!!!!!!!!!
Barbie
