Ashley Posted Mon 20th of June, 2016 08:54:29 AM
Cephanlic Vein and Cephanlic Arch is this considered in the same segment or can we will for both area if intervention was done? Attached a note for reference. thanks
After informed consent obtained the patient was prepped and draped in usual sterile fashion. Timeout confirmed patient, site, and procedure with all staff present. 1% lidocaine infiltrated locally and the left brachiocephalic AV fistula was accessed with an 18-gauge angiocatheter. Angiogram revealed that the access zone of the AV fistula was patent. The arterial anastomosis including the proximal stent was patent. The outflow across the cephalic arch showed no flow into the cephalic arch with to collateral veins emptying into the subclavian. A 0.035 Glidewire was advanced into the cephalic vein and a 7 French sheath placed over the wire. With the use of a Kumpe catheter I was eventually able to get the Glidewire crossed over the cephalic stenosis into the subclavian vein I advanced a 7 millimeter balloon year and inflated until waist resolved. Followup angiogram showed persistent stenosis now large infiltration. I reinflated the balloon until is able to prepare a 7 millimeter by 8 centimeter stent which I placed across the stenosis and infiltrated area. The balloon was opened with a 7 millimeter Vaccess. Followup angiogram showed no residual extravasation and excellent result with no residual stenosis. Next I didn't angioplasty of the cephalic vein distal to the stent with a 7 millimeter Vaccess at the site with 50% stenosis. Followup and gram showed no residual stenosis. This point procedure was terminated. Sheath removed and hemostasis achieved with gentle compression. Patient to recovery in stable condition.
SuperCoder Answered Tue 21st of June, 2016 03:48:47 AM
“AAE does not provide coding for operative reports and chart notes.
SuperCoder offers SuperCoding on Demand (SOD) (http://www.supercoder.com/coding-answers/coding-on-demand) for coding of an operative report or chart note and you can contact (866)228-9252 or e-mail firstname.lastname@example.org for more information. ’
Ashley Posted Tue 21st of June, 2016 08:49:03 AM
I am not asking to code a op report I am asking if Cephalic Vein and Cephalic Arch is considered to be in the same segment or can we will for both area if intervention was done?
I was just giving an example op report for more info if needed. thanks
SuperCoder Answered Wed 22nd of June, 2016 08:15:46 AM
I think both should fall in the same segment.
Ashley Posted Wed 22nd of June, 2016 09:16:52 AM
So you said you think how can we be for sure that they are in same segment sorry but I am getting mixed answer from doctors etc. and just want to be sure it is being done correctly.
SuperCoder Answered Thu 23rd of June, 2016 07:07:46 AM
Though there isn't a specific article on this, however, you may find the following article helpful that shows the link between the cephalic arch and vein. It is given under the heading "Stent Graft for Cephalic Arch Stenosis". http://cjasn.asnjournals.org/content/5/7/1347.full#ref-22
Hope this helps!!