Occlusion and stenosis of left carotid artery [I65.22 (ICD-10-CM)]
Atherosclerotic heart disease of native coronary artery without angina pectoris [I25.10 (ICD-10-CM)]
Swelling of limb [M79.89 (ICD-10-CM)]
Conclusion

81-year-old male with symptomatic left sided high risk carotid stenosis referred for diagnostic carotid angiogram. Procedure, risks, benefits, alternative options were explained. Risks including bleeding, infection, cerebrovascular accident, myocardial infarction, death, and arrhythmia were all explained patient was agreeable. He was brought into the cardiac cath lab where Both groins were prepped and draped in the usual fashion. 2% lidocaine was used to anesthesize the skin. Using modified Seldinger technique, a 5 French sheath was inserted in the right femoral artery. Arch angiogram was performed with a pigtail. A 5 French v TK catheter was used to perform the selective carotid angiogram finding:
1: Type I bovine aortic arch
2: Left common carotid artery is very tortuous. There is severe more than 90% stenosis of the distal common carotid artery into the proximal left carotid bulb. Cerebral angiogram showed poor flow into the anterior cerebral artery.
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Impression: Severe stenosis in the distal left common carotid artery into the proximal left internal carotid artery as mentioned above
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Plan: We will discussed with the patient medical management versus carotid stenting. Patient was deemed high risk for carotid endarterectomy by vascular surgery consultation.
thank you in advance
I am thinking 36222 ?