AHA Coding Clinic® for HCPCS - 2022 Issue 4; Ask the Editor

Catheter placement and angiogram due to tortuosity

A patient was taken to the cardiac catheterization lab to assess their coronary artery disease. The right radial artery was cannulated and a glidewire was used to traverse the radiobrachial junction. The catheter was not able to cross into the ascending aorta due to marked tortuosity in the subclavian segment. Angiography was then performed of this segment, which showed calcification and confirmed a 270-degree angle of the subclavian. Therefore, the procedure was changed to a femoral approach. The right femoral artery was cannulated with a 5-French sheath and coronary angiography was performed using catheters for the right and left coronary arteries. The right coronary catheter was then used to cannulate the tortuous innominate artery showing the subclavian to be patent; aortic arch angiography was also performed. A left heart catheterization and left ventricular cineangiograms were then completed. Can the selective catheterization of the radial artery with angiogram of the extremity including the subclavian segment, be reported separately in this case? ...

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