Ask Dr. Z

Is there a code for test occlusion, 37246? "A 5 Fr Berman was advanced via the RFV to RA to the RV to the AAO and an angiogram was performed. The Berman was advanced into the right innominate artery and the balloon was inflated at the mouth of the BT shunt. The oxygen levels dropped significantly to the low 60's. An ABG was obtained and the FIO2 was increased to 50%. The balloon was inflated at the mouth of the shunt for a few minutes time and the pulse oximetry numbers dropped from the high 70's to the low 60's. The PA pressure and aortic pressure were measured with temporary occlusion. Given the hypoxia the decision not to occlude the BT shunt.Findings: Widely patent Glenn shunt and pulmonary arteries, acceptable PA presures and SVC pressure, large veno-venous collateral decompressing the Glenn via extensive paravertebral network which eventually reaches the IVC, patent BTS with good flow to both branch pulmonary arteries, mild pulmonary venous desaturation, widely patent Norwood and aortic arch and no AP collaterals."