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Peripheral Angiography Coding

Tommy Posted Wed 19th of March, 2014 15:11:35 PM

These always stump me. The description in report is below. I believe I would charge
I want to know if this is correct. Also that I do not need to append a modifer 59 as it was all diagnostic.

TECHNIQUE: Patient was prepped and draped in the usual fashion. After
local anesthesia with 2% Xylocaine, a short 5-French sheath was placed
in the right femoral artery using percutaneous technique. A 5-French
pigtail catheter was then advanced over a 0.035 guidewire to the
descending aorta and positioned just below the diaphragms.
Abdominal aortography was then performed in 2 injections, both using
digital subtraction techniques. The upper descending aorta at the level
of the diaphragm to the renal arteries was then injected with a total of
30 mL of contrast injected at a rate of 15 mL/ second. This catheter was
then withdrawn back to the iliac bifurcation. Injection at this point
demonstrated the lower portion of the descending aorta just above the
iliac bifurcations. A total of 30 mL of contrast was injected at a rate
of 15 mL/second. I then took a 5-French IMC angiographic catheter with
a 0.035 angled Terumo Glidewire into the left superficial femoral
artery. I then placed a 5-French straight glide catheter into the left
external iliac. We then injected the left iliac femoral system using a
total of 40 mL of contrast injected at a rate of 6 mL/ second. We were
able to record this using cineangiography. This catheter was then
pulled back into the right external iliac and in a similar fashion 40 mL
of contrast was injected at a rate of 6 mL/ second. We also followed
this all the way down to the ankle because of a total occlusion of the
right popliteal. I then removed this catheter and injected through the
femoral sheath, which is in the right femoral artery. This injection
through this sheath allowed us to demonstrate the total occlusion and
the vessels immediately distal to it using digital subtraction
techniques. A total of 36 mL of contrast was injected at a rate of 6
mL/ second . There were no complications during this procedure. At the
end of the procedure the sheath was removed and hemostasis was achieved
prior to returning the patient to the floor in good condition without
chest pain or shortness of breath.

The remaining report gives full individual description of each area but where he put catheters and injected is in the above description.
Thanks for your help

SuperCoder Answered Thu 20th of March, 2014 09:52:10 AM


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