Ask Dr. Z

Patient brought into the suite for an abdominal arch angiogram. The physician puts the cath into the arch and performs the angiogram. He documents he was satisfied. Then he writes I should note he attempted to cath LCC but could not because the catheter kept slipping out. The auditor coded 36222-LT/74. I suggested 36221. I am curious about provider's intent. The op-report states he went to shoot the arch. Do you give him credit for attempting the LCC even though that was not his intent? This comes up often in our hospital. The physician set out to do one thing, and while he is in there he attempts something else and does not succeed. When does intent kick in?