Ask Dr. Z

"Study carried out via the right common femoral artery utilizing 6 French catheters. The Judkins technique was used for bilateral selective coronary angiography. Left ventriculography was deferred. I placed a second sheath in vessel due to instability and small hematoma, to document absence of residual leak. Sheath left in place to monitor BP on a continuous basis. Subclavian and peripheral angio: This vessel is heavily calcified. There is 70% short concentric stenosis in the vessel but does not involve the ostium. This lesion was engaged coaxially with a 6 French JR 4.0 Mach 1 catheter. There was dampening of pressures when coaxial engagement was carried out; nonetheless, I was unable to pass a 0.35 mm Rosen, Wholey, or Terumo angled guidewire across the lesion." He wanted 93454, 75710, 36215, but I don't see that he gets cath plament in subclavian because he never states where the cath is placed. How would you code this?