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Lower extremity angiography and intervention

Bridget Posted Mon 10th of November, 2014 17:07:23 PM

Hello, we want to be sure we are coding correctly. How would you code this? Thank you

Procedure: Abdominal aortography with iliofemoral angiography and runoff studies.
Indication: PVD with right leg claudication.

Description: The left common femoral artery was cannulated and a 7-French introducer sheath was inserted over a guidewire. Left iliofemoral angiography and femoral popliteal antiography was performed by injecting through the left femoral artery sheath. A 5-French Omniflush catheter was then taken up into the abdominal aorta over a .35 starter wire. It was positioned above the renal arteries and used to perform abdominal aortography. It was then pulled down just above the aortic bifurcation and used to perform an aortoiliac angiography. The omniflush catheter was then taken up and over the aortic bifurcation and over a .35 angled glidewire and positioned down in the right common femoral artery. It was then used to perform right femoral popliteal angiography.

Aortoiliac angiography: The abdominal aorta is normal in caliber. It has some mild diffuse atherosclerotic changes, but no significant aneurysmal dilation. Both kidneys appeared to be supplied by patent renal arteries. There may be 2 renal arteries on the right. The left kidney appears to have a single renal artery. These arteries are free of significant disease.
The common iliac arteries are free of significant disease bilaterally. There is a stent extending from the left common iliac down into the left external iliac artery which is widely patent. The left internal iliac artery is small and diffusely disease. The right common iliac artery has at most a few minor liminal irregularities. The right external iliac and right internal iliac arteries are free of any significant disease.

Femoral popliteal angiography: 1. Left fem pop system- left common femoral artery is free of significant disease. The profunda is patent with good runoff. The left SFA has scattered areas of 30-40% proximal and mid narrowing. There is a stent in the mid to distal vessel which has at most 30% narrowing in the proximal portion and 20-40% narrowing in the proximal portion and the 30-40% narrowing in the distal portion and just below the stented segment. Below the knee, there is 3-vessel runoff to foot.
2. Right femoral popliteal angiography - the right common femoral artery is widely patent with no significant disease. The profunda is also patent with no significant disease. The right SFA has areas of 30% proximal narrowing. There is a stent in the mid vessel which has 80% in stent narrowing. Below the knee, there is a 3-vessel runoff to the foot.

Final Impression: Right superficial femoral artery stenosis with a previously implanted stent. Plan: We plan to procede with intervention to readdress this area.

Procedure performed: Right SFA laser atherectomy followed by balloon angioplasty. Indication: Right SFA stenosis with limiting claudication.

Description: Sheath positioned in the proximal right SFA. The SFA lesion crossed with a wire and debulked with a laser catheter. Three passes made and it was treated with angiosculpt catheter12 asmospheres for 5 min and 6 astmospheres for 3 min. Overall, excellent angiographich results with good runoff into the distal vessel at the end of the procedure.

SuperCoder Answered Tue 11th of November, 2014 04:05:31 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 may contact (866)228-9252 or e-mail customerservice@supercoder.com for more information.

Thanks !!

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