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Tag Archives: Balloon

You’ll Need This to Get Balloon Dilation of the Eustachian Tube Paid

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Clinical Consensus Statement: Balloon Dilation of the Eustachian Tube (BDET), published by the American Academy of Otolaryngology  ̶  Head and Neck Surgery, June 4, is important because BDET is newer technology and may be rejected for payment by third-party payers as “experimental” or “investigational.” The American Academy of Otolaryngology’s (AAO) statement will be integral to […]

The post You’ll Need This to Get Balloon Dilation of the Eustachian Tube Paid appeared first on AAPC Knowledge Center.

AAPC Knowledge Center

Colonoscopy with balloon dilatation

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Hello fellow coders,

I’m in need of your opinions on the coding of the below op report. Optum is denying my claims stating that the services are not supported due to no documentation within the op report that the colonoscope went to the cecum. Per CPT book the definition of a colonoscopy is the examination of the entire colon, from the rectum to the cecum, and may include the examination of the terminal ileum or small intestine proximal to an anastomosis.

A digital rectal exam was performed revealed no masses. After adequate IV sedation given, Olympus pediatric colonoscope was inserted into the patient’s rectum and advanced around the ileocolonic anastomosis. The patient had scarring with the ascending colon from previous Crohn disease. The anastomosis was strictured down and the scope could not be advanced through this area. A 12-13.5-15 mm wire-guided balloon was advanced through the anastomosis. The balloon was inflated to 12mm held there for 1 minute. The balloon was inflated to 13.45 mm and held there for 1 minute. The balloon could be advanced through the anastomosis. Some active inflammation and ulceration was noted within the terminal ileum. Biopsies were obtained from the terminal ileum. The remainder of the ascending colon, hepatic flexure, transverse colon, splenic flexure, descending colon, sigmoid colon and rectum were normal.

Coded As:
:confused:
45386
45380-59

Thank you in advance for your opinions.

Medical Billing and Coding Forum

need help with vein graft balloon angio only

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PROCEDURES
1. Coronary angiogram
2. Left heart catheterization
3. Graft angiogram
4. Percutaneous intervention and balloon angioplasty of vein graft to OM1.
5. Right iliofemoral angiogram

PROCEDURE NOTE
Informed consent was obtained after explaining risks and benefits to the patient. Right groin was draped and prepped in a sterile fashion. Patient was premedicated with 1.5 mg Versed and 100 mcg fentanyl IV. After injecting 2% lidocaine, right common femoral artery was accessed with the help of micropuncture with some difficulty due to previous scarring and 6 French femoral sheath was inserted. 6 French diagnostic catheters were used to cannulate left and right coronary artery. 6 French FR 4 catheter was also used to cannulate the vein grafts. Patient was proceeded with intervention of the vein graft of obtuse marginal branch. Overall patient tolerated procedure well. Right iliofemoral angiogram was performed and femoral sheath was pulled and manual pressure was applied for 20 minutes with good hemostasis. FemoStop was applied at Bell pressure for persistent hemostasis.
*
LEFT HEART CATHETERIZATION
Left ventricular end diastole pressure was 18 mmHg. No significant gradient across aortic valve.

CORONARY ANGIOGRAM
1. Left main was calcified with 70-80% distal stenosis.

2. Left anterior descending artery had severe diffuse disease proximally before it was 100% occluded for previous stents

3. Left circumflex artery was 100% occluded proximally

4. Right coronary artery was under percent occluded at the origin.
*
GRAFT ANGIOGRAM
1. Vein graft to LAD was under percent occluded (chronic)
2. Vein graft to RCA was patent. Stent was noted in the mid body of the graft which was patent with 80% in-stent restenosis. 50-60% stenosis noted in distal RCA after anastomosis before the bifurcation of PDA and PLV branches. PDA branch was patent with no significant disease given collaterals to distal LAD. PLV branch was patent.
3. Vein graft to obtuse marginal branch was patent with TIMI II antegrade flow. Stent at the ostium had 99% in-stent restenosis. There was also 80-90% stenosis of mid part of the body of the graft within the previous stent. Distal part of the vein graft was patent.
*

PERCUTANEOUS INTERVENTION OF VEIN GRAFT OBTUSE MARGINAL BRANCH
6 French JR4 guide catheter was used to cannulate the vein graft to OM 1. Heparin was used for anticoagulation. Initially filter wire was attempted for distal protection which was unsuccessful to advance due to significant ostial stenosis. 0.014 BMW guidewire was advanced and vein graft to OM stenosis was successfully crossed without difficulty. 2.5 x 15 mm noncompliant balloon was advanced and both lesions of vein graft was predilated at 16 followed by 18 atm. Nitroglycerin intracoronary was given. Subsequent angiogram revealed TIMI-3 antegrade flow and distal part of the body of the graft but still residual significant stenosis at the ostium. 3.5 x 15 mm noncompliant balloon was advanced and both lesions of vein graft were dilated at 16 atm couple of times. Adenosine followed by nitroglycerin were given through guide catheter. Subsequent angiogram revealed wide-open vein graft to OM with TIMI-3 antegrade flow and no evidence of dissection or perforation. No evidence of distal embolization. Patient was hemodynamically stable and asymptomatic at the end of procedure.

RIGHT ILIOFEMORAL ANGIOGRAM
Right common femoral artery was patent. Sheath insertion was just below the origin of the inferior epigastric artery..

IMPRESSION
1. Severe native 3 vessels coronary artery disease.
2. Patent vein graft to OM1 with 99% ostial stenosis within the stent as well as 80% instent restenosis within the mid body of the graft. (Likely culprit)
3. Patent vein graft to RCA with 80% in-stent restenosis.

RECOMMENDATIONS
Patient has complex coronary disease as described above. He had multiple intervention of vein graft in the past including 3 intervention in vein graft to OM last year. He has significant instent restenosis of drug-eluting stents. Recommend evaluation by cardiac surgery for possible redo CABG. Continue aggressive medical treatment.
*
should I do 93459,92937 -lc since this is vein graft balloon angio or 92920? I bill for hospital
thanks in advance

Medical Billing and Coding Forum

Embolization with coils balloon and stent

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Hi I’m looking for some guidance for coding the following procedure. Any help would be greatly appreciated :)

*
INDICATION: 57 y.o. female with multiple cerebral aneurysms
*
COMPARISON: CTA performed on
*

*
ANESTHESIA: General Anesthesia.
*

*
CONSENT:
The procedure, risks, benefits and alternatives to cerebral angiography were discussed with the patient. Informed consent was obtained after all questions were answered. The patient was brought to the Neuroendovascular suite and placed supine on the angiography table. The patient was prepped and draped in the usual sterile fashion.
*
DESCRIPTION OF THE PROCEDURE AND FINDINGS:
ACCESS:
The skin of the right wrist was anesthetized with EMLA cream and 2% lidocaine subcutaneously. Utilizing US guidance and a micropuncture kit, a 6 Fr. Terumo slim glidesheath was placed into the right radial artery. 2D hand injected angiography was performed which demonstrates retgrade opacification of the radial artery, ulnar artery and superficial palmar arch. Heparin 5000 units, 200 mcgs Nitroglycerin and 5 mg verapamil was adminsitered intra-arterially.
*
Intravenous heparin was administered with intermittent boluses to maintain an ACT 2 – 2.5 times the patient’s baseline.
*
A 6 French 071 Benchmark guide catheter over a Simmons-2 catheter and an angled 0.038" Terumo Glidewire was advanced into the right brachial artery.
*
RIGHT VERTEBRAL ARTERY:
The guide catheter was advanced into the right vertebral artery. 2D hand injected angiography was performed centered over the neck and head. The cervical vertebral artery is of normal course and caliber. Intracranially, there is antegrade opacification of the right vertebral artery, right posterior inferior cerebellar artery, basilar artery, bilateral anterior-inferior cerebellar arteries, bilateral superior cerebellar arteries, bilateral posterior cerebral arteries and their branches. The left distal vertebral artery backfills briefly with opacification of the left posterior inferior cerebellar artery. The vessels are of normal course, caliber and taper regularly. There is no aneurysm, focal area of stenosis or early draining vein. The capillary and venous phases are unremarkable. The dural and deep venous sinuses opacify normally.
*
LEFT COMMON CAROTID ARTERY:
The guide catheter was advanced into the left common carotid artery. 2D hand injected angiography was performed centered at the bifurcation which is at the C2/3 level. The carotid bifurcation is widely patent without atherosclerotic disease or hemodynamic significant stenosis. The cervical internal and external carotid arteries are of normal course and caliber.
*
LEFT EXTERNAL CAROTID ARTERY:
The guide catheter was advanced into the left external carotid artery. 2D hand injected angiography was performed centered over the patient’s head. Angiography reveals antegrade opacification of the external carotid artery and its branches. The vessels are of normal course, caliber and taper regularly. No aneurysm, focal area of stenosis or early draining vein is seen to suggest a fistula.
*
LEFT INTERNAL CAROTID ARTERY:
The guide catheter was advanced into the left internal carotid artery. 2D hand injected cerebral angiography was performed in the AP, lateral and oblique projections. Angiography reveals antegrade opacification of the internal carotid artery, middle cerebral artery, anterior cerebral artery and their branches. The posterior communicating artery is small, fills the posterior cerebral artery and rapidly clears from competitive flow. The vessels are of normal course, caliber and taper regularly. There is no focal area of stenosis or early draining vein. The capillary and venous phases are unremarkable. The dural and deep venous sinuses opacify normally. There is a 2.2 mm x 2.4 mm left ophthalmic artery aneurysm.
*
RIGHT COMMON CAROTID ARTERY:
The guide catheter was advanced into the the right common carotid artery. 2D hand injected angiography was performed centered at the bifurcation which is at the C2/3 level. The carotid bifurcation is widely patent without atherosclerotic disease or hemodynamic significant stenosis. The cervical internal and external carotid arteries are of normal course and caliber.
*
RIGHT INTERNAL CAROTID ARTERY:
The guide catheter was advanced into the right internal carotid artery. 2D hand injected cerebral angiography was performed in the AP, lateral and oblique projections. Angiography reveals antegrade opacification of the internal carotid artery, middle cerebral artery, anterior cerebral artery and their branches. The posterior communicating artery is robust, fills the posterior cerebral artery and rapidly clears from competitive flow. The vessels are of normal course, caliber and taper regularly. There is no focal area of stenosis or early draining vein. The capillary and venous phases are unremarkable. The dural and deep venous sinuses opacify normally. There is a 2.9 mm x 6.1 mm right posterior communicating artery aneurysm with a 3 mm neck. There is a 3.6 mm x 3.5 mm right paraophthalmic aneurysm with a 2.5 mm neck. There is an occlusion of a distal parietal middle cerebral artery branch with delayed opacification of the downstream territory. 7.35 mg of Integrilin were administered to the right internal carotid artery.
*
EMBOLIZATION:
The right internal carotid artery was selected and under roadmap guidance and 10 mg of verapamil was administered. The guide catheter and glidewire were advanced into the cervical segment of the internal carotid artery. The Simmons-2 catheter and glidewire were removed. Follow-up control angiography was performed which is unchanged from the initial angiogram and demonstrated no vasospasm around the guide catheter. There is slight improvement in opacification of the occluded distal parietal middle cerebral artery branch.
*
Utilizing a road map a 4 mm x 10 mm Scepter C balloon was advanced over a 0.014" Synchro-2 guidewire across the right posterior communicating artery aneurysm os. A 45 degree SL-10 microcatheter was advanced over a 0.014" Aristotle guidewire into the right posterior communicating artery aneurysm. An aneurysmogram was performed which demonstrates opacification of 2.9 mm x 6.1 mm aneurysm with a 3 mm neck.
*
Balloon assisted coil embolization of the aneurysm was performed by advancing a TARGET 360 SOFT 5X10 coil into the aneurysm. This was followed by a TARGET 360 ULT 4X10 coil, which prolapsed out of the aneurysm sac. The coil was removed and the balloon deflated, resulting in a coil loop prolapsing into the right internal and right middle cerebral arteries. The 45 degree SL-10 was removed. A 90 degree SL-10 microcatheter was advanced over a 0.014" Aristotle guidewire into the right posterior communicating artery aneurysm under roadmap control. Balloon assisted coil embolization of the aneurysm was performed by advancing the TARGET 360 ULT 3X8 coil. Control angiography demonstrates a coil loop within the right middle cerebral artery and the right internal carotid artery, otherwise the remaining coils are well seated in the aneurysm sac and the parent vessel to be widely patent.
*
Coil embolization of the aneurysm was performed by advancing the following coils into the aneurysm sac:
TARGET 360 ULT 3X8
TARGET 360 ULT 3X6
TARGET 360 ULT 2X4
*
Follow up control angiography was performed demonstrating a coil loop within the right middle cerebral artery and the right internal carotid artery, otherwise the remaining coils are well seated in the aneurysm sac and the parent vessel to be widely patent.
*
Utilizing a road map the 4 mm x 10 mm Scepter C balloon was advanced over the 0.014" Synchro-2 guidewire across the right paraophthalmic aneurysm os. The 90 degree SL-10 microcatheter was advanced over the 0.014" Aristotle guidewire into the right paraophthalmic aneurysm. An aneurysmogram was performed which demonstrates opacification of 3.6 mm x 3 mm aneurysm with a 2.8 mm neck.
*
Balloon assisted coil embolization of the aneurysm was performed by advancing a MICRUSFRAME 10 3.5X6.6 coil into the aneurysm sac. Control angiography demonstrates the coil mass seated in the aneurysm sac and the parent vessel to be widely patent.
*
Coil embolization of the aneurysm was performed by advancing the following coils into the aneurysm sac:
GALAXY G3 MINI 2.5X4.5
GALAXY G3 MINI 2X3
*
The Scepter C balloon and SL-10 catheter were removed.
*
Under high magnification fluoroscopic roadmap control, a 4.5 mm x 21 mm Neuroform Atlas stent was positioned from the right carotid terminus to the cavernous segment segment of the right internal carotid artery utilizing a XT-17 over the 0.014" Aristotle guidewire and deployed.
*
Control angiography demonstrates a coil loop arising from the right posterior communicating artery aneurysm coil mass into the right middle cerebral artery, with the remaining coils to be well seated in the aneurysm sac and the parent vessel to be widely patent with no opacification of the aneurysm sac, but persistent filling of the aneurysm neck (Raymond 2). Additionally, there is a coil mass seated in the right paraophthalmic aneurysm with no opacification of the aneurysm sac (Raymond 1). There is no evidence of in stent stenosis or thrombosis, and the stent is well apposed to the parent vessel wall.
*
The XT-17 microcatheter and guidewire were removed. Final follow-up control angiograms were performed in the AP, lateral and working projections which demonstrated the coil mass to be well seated within the aneurysm sac and the parent vessel to be widely patent. There is persistent occlusion of the distal parietal middle cerebral artery branch with delayed opacification of the downstream territory.
*
After review of the angiographic data the guide catheter was removed. The right radial artery sheath was removed. Hemostasis was achieved utilizing a TR-Band. The patient tolerated the procedure well. The patient was subsequently transferred to the Neuroendovascular Surgery recovery area at their baseline neurological status.
*
IMPRESSION:
1. Balloon assisted coil embolization of a non-ruptured, right posterior communicating artery aneurysm measuring 2.9 mm x 6.1 mm with a 3 neck. There is no opacification of the aneurysm sac, but persistent filling of the aneurysm neck (Raymond 2). There is a coil loop in the right internal carotid and right middle cerebral arteries.
2. Successful balloon assisted coil embolization of a non-ruptured, right paraophthalmic aneurysm measuring 3.6 mm x 3.5 mm with a 2.5 mm neck. There is no opacification of the aneurysm sac (Raymond 1).
3. Atlas stent deployment from the right internal carotid terminus into the cavernous segment of the right internal carotid artery, successfully tacking down the prolapsed coil loop.
4. Occlusion of the distal parietal middle cerebral artery branch with delayed opacification of the downstream territory treated with Integrilin infusion.
*
MY CPT CODES

61624
36226 RT
36224 50
36228 X 2
75894 26
75898 X 2
NOT SURE ABOUT THE ATLAS STENT

Thank you!

Medical Billing and Coding Forum

LE shockwave balloon lithotripsy

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Hello

One of my physicians performed an intravascular lithotripsy in the common iliac artery using the Shockwave Balloon. Has any one billed for this? I have researched and have found nothing so I am assuming it will be an unlisted CPT code. I thought I would just throw this out there in case someone else has done this procedure.

thanks!

Dolores

Medical Billing and Coding Forum

Aortic balloon Valvuloplasty with heart cath

Posted on by
I feel like I’m missing something, can someone verify it for me, appreciate it a lot :)

Codes
92986
99152
76937-26
93542-26

PROCEDURES PERFORMED:
1. Aortic balloon valvuloplasty x3 across the aortic valve.
2. A 12-French side-arm sheath was placed in right femoral arteriotomy with
Perclose device. At the end of the case, Percloses were performed as well as
manual pressure given some bleeding.
3. Moderate sedation.
4. Ultrasound for vascular access.
5. Supervision and interpretation of above.
6. Left heart catheterization.
7. Left ventriculogram.

INDICATION:
The patient is an 85-year-old, Caucasian male with recent worsening shortness
of breath, pleural effusions with severe paradoxical calcific aortic stenosis
as well as multivessel coronary artery disease. I was asked by Dr. Joseph Quan
for further evaluation for balloon valvuloplasty with likely transcatheter
aortic valve replacement in the future. Informed and witnessed signed consent
was placed in the patient’s medical record. The patient understood the risk,
benefits, alternatives to balloon valvuloplasty and likely stents with Dr.
xxxxx and myself, wished to proceed with procedure. Risks include, but
are not limited to stroke, myocardial infarction, renal failure, bleeding, limb
loss, aortic insufficiency, and death.

DESCRIPTION OF PROCEDURE:
The patient was brought to the cardiac catheterization laboratory in the
fasting state. Both groins were prepped and draped in sterile fashion.
Because of Angio-Seal and prior cardiac catheterization by Dr. xxxx on
the right, we went into the left femoral artery using modified Seldinger
technique, ultrasound and micropuncture kit. With a 6-French sheath in place,
Perclose sutures were affixed. Next, upsized to a 12-French side-arm sheath.
There was some calcium noted, however, was able to place a 12-French side-arm
sheath into the femoral artery. Next, with the Amplatz AL1 and straight wire,
we were able to cross across the valve and pressures were measured with pigtail
catheter. Next, left ventriculogram was also performed. Next, I proceeded
with placement with an Amplatz extra stiff wire into the left ventricle.
Balloon valvuloplasty was performed with a Bard true flow balloon at 20 mm up
to compliant pressure x3 across the aortic valve. Pigtail catheter on pullback

showed no changing gradient suggesting successful balloon valvuloplasty. Next,
continue with the rotablation part of the procedure. Please see Dr. xxxx note. In addition, prior to balloon valvoplasty, a pacemaker device was
placed using modified Seldinger technique and ultrasound with sheath access in
the right femoral vein and a balloon tipped pacemaker placed in the right
ventricle wire.

RESULTS:
1. Successful balloon valvoplasty x3 across the aortic valve with no gradient
at the end of the case.
2. Proceeded with coronary stent placement.

RECOMMENDATIONS:
1. The patient will have staged procedure with CSI atherectomy and balloon
angioplasty and stent placement on November 20th and will come back likely in
mid December for transcatheter aortic valve replacement when all the workup is
complete for that.
2. Groin precautions x1 week. Bed rest for at least 10 hours with Femstop in
left femoral artery.

Medical Billing and Coding Forum

Lower extremity and balloon angioplasty of RT common femoral

Posted on by
Can someone give some guidance from PCI to lower extremity angiography .. may have my PCI code incorrect but definitely missing more…help please!

Codes:
93458-26,59
76937-26
92928-LC
???

PRECATHETERIZATION DIAGNOSIS:
CAD.

POSTCATHETERIZATION DIAGNOSIS:
CAD. Right groin hematoma. No active bleeding at cath site in the right common femoral artery.

PROCEDURE PERFORMED:
Left heart catheterization, left ventriculography, selective coronary angiography via the right transfemoral approach.
US vascular access. Balloon angioplasty of the OM branch. Right common iliac and right common femoral
angiography. Balloon angioplasty of the right common femoral artery for bleeding.

CLINICAL FEATURES:
70 year old black female with DM, dyslipidemia underwent stenting of OM on 2-22-18 with a 2.25 x 16 mm Synergy
stent. Her Lexiscan on 9-20-18 suggested distal anterior wall stress ischemia. She underwent renal transplantation
years ago.
In view of of an abnormal myocardial perfusion stress test and known coronary artery disease having had
coronary stenting on 2/22/18, recommend cardiac catheterization to assess coronary status and to undertake
appropriate treatment.
The patient understands the nature, purpose, alternatives, benefits and risks of cardiac catheterization and
possible PCI, including but not limited to the effects of conscious sedation, myocardial infarction, emergency
cardiac surgery, bleeding, CVA, renal failure, compromised circulation in the extremities, and rarely fatal
complications and the patient offers an intelligent consent.

PROCEDURE:
After an informed consent was obtained, the procedure was undertaken via the right transfemoral approach. The right
groin was infiltrated with xylocaine and the right common femoral artery was entered and a sheath was placed in the
artery. Micropuncture technique was used with US vascular access. Left ventriculography and left coronary
arteriography were done using a JL 4 cm Judkins catheter. Right coronary arteriography was done using a 4 cm right
Judkins catheter.
Having noted instent restenosis in the OM branch, intervention was undertaken using a 3.75 cm EBU guiding
catheter, a Runthrough wire and balloon dilation was done using a 2.0 x 12 Emerge balloon catheter followed by
dilation with a 2.5 x 12 NC Quantum balloon and followed by 2.5 x 6 mm AngioSculpt scoring balloon with multiple
dilations. Having noted a satisfactory result, a AngioSeal was deployed. Sheath angiography was done at the
beginning of the procedure and it indicated no abnormality and the sheath insertion site was in the common femoral
artery. Care was taken to use an exchange wire because she had renal transplant on the right side. An AngioSeal
was deployed.
In the recovery room, it was noticed that she had a hematoma in the right groin. Manual pressure was appliedfor 20
minkute. During observation, she developed a vasovagal episode with hypotension which gradually improved.
To exclude significant bleeding, angiography was undertaken from the contralateral side.The left groin was infiltrated
with xylocaine and with US aid and using micropuncture technique, the left common femoral artery was entered. Using
Omnifush catheter and angled glide wire, the catheter was advanced into the left common iliac artery and contrast
injection was done. Subsequently angiography by hand injection of the iliac arteries and the right common femoral
artery was done. No evidence extravasation was noted. The right inferior epigastric artery was somewhat irregular but
no dissection or perforation was noted.
Balloon dilation of the right common femoral artery was done using a 6 x 60 mm Abbot’s Armada balloon which was
inflated for 3 minutes, just to tamponade any possible oozing that is not readily visible. The patient tolerated the
inflation well. Post dilation angiography was done. No evidence of perforation noted. No extravasation noted.The
patient was hemodynamically stable.

INTERPRETATION:
1. Hemodynamics: Please consult the hemodynamics data.
2. Left ventriculogram: Normal contractility with estimated EF at 60% The presence of a stent noted.
3. Coronary cine arteriogram:
A. Left main coronary artery: Stented vessel patent.
B. Left anterior descending artery: Free of significant disease.
C.Circumflex coronary artery: In-stent restenosis of the OM branch (90%) noted.
D. Right coronary artery:Free of significant disease.
4. Result of intervention:
The 90% instent restenosis in the OM branch was subjected to balloon angioplasty and AngioScult scoring balloon
angioplasty with a satisfactory result with minor residual narrowing. Since the branch is small, it was not deemed
prudent to deploy another stent in the vessel, crowding a small artery.
5. Angiography of the right pelvic arteries.
A. The right iliac arteries are patent. Evidence of kidney transplant noted.
B. The right common femoral artery was patent without obvious evidence of bleeding.Irregularity of the inferior
epigastric artery without perforation or dissection noted.
6. Balloon angioplasty of the right common femoral artery:
Balloon dilation was done to seal any possible oozing from the arterial puncture site.

FINAL DIAGNOSIS:
Normal LV function and in-stent restenosis in the OM branch with successful balloon angioplasty. She had right groin
hematoma and angiography showed normal right sided iliac arteries and femoral artery with no definite bleeding.
Balloon angioplasty of the right common femoral artery was done to seal any possible oozing which was not readily
apparent.

Medical Billing and Coding Forum

Single and double balloon enteroscopy

Posted on by
Good morning. Can the code range 44360 through 44378, small intestinal endoscopy, enteroscopy be reported for single and double balloon enteroscopy via the antegrade approach? I realize the retrograde approach would be reported with the unlisted procedure code. I am finding mixed information, some state unlisted procedure code and others refer to codes 44360-44378.

Thank you in advance for any information.

Medical Billing and Coding Forum

Multiple Cardiology Procedures: Cath/renal angiography with balloon angio and stent

Posted on by
New to cardiology and I think I’m getting myself overwhelmed when searching for the codes but I want to learn. I know some of these are included in others but still confused, HELP please!:confused:

Procedure Performed:
1. RT and LT heart Catherization
2. Aortic valve study
3. Left ventriculogram
4. Coronary angiography
5. Distal abdominal aortography
6. Selective renal angiography with balloon angioplasty and stent placement with a 5.0x18mm heculink placed in the left renal artery proximal.
8. Sheath suture in place. Plan for manual pressure, hold 2 hr post procedure
9. Supervision and interpretation of above.

Medical Billing and Coding Forum