Ask Dr. Z

"Patient had an access from the left groin previously. We advanced an Omni Flush catheter and crossed over to the right common femoral artery, advanced a Supra Core wire beyond the level of the sheath into the right SFA, and advanced a 7 French sheath into the right external iliac artery. We then advanced a wire through the side port of the 14 French sheath, through which Impella device had been placed, and we removed the Impella CP device successfully out of the body. We placed a 12 French sheath into this access site, and continued bleeding around the sheath was noted. We advanced an 8.0 x 40 mm balloon into the right external iliac artery and inflated it to 10 atmospheres to achieve balloon tamponade. Following that, through the wire that has been placed in the right CFA, we performed the Perclose using a ProGlide device. We then advanced the balloon into the common femoral artery access site and performed balloon tamponade for 20 minutes." After Impella removal 33992, I'm not sure what else we can code. Thoughts?