Ask Dr. Z

I am unsure how to code this delayed endoleak repair. What codes would be best used for the Amplatzer plug and angioplasty?

"A J wire was advanced into the abdominal aorta, and a 5 French sheath was inserted. 2 perclose systems were deployed in the right femoral artery, and an 8 French sheath was advanced. A glide wire was used to get access in the arch, and a pigtail was advanced on it. Then the left brachial artery was percutaneously punctured and a 6 French sheath was inserted as above. Heparin was administered and ACT maintained at about 300 seconds. A glide wire was used on the left arm to get access to the left carotid artery. A 10 x 30 injection of the descending aorta was obtained and the endoleak seen. A 22 mm Amplatzer plug was advanced from the left arm and deployed in the false lumen and in the origin of the subclavian artery. A new angiogram showed no endoleak. Then a Coda balloon was advanced and the distal part of the stent was fully expand, and a completion angiogram showed a decrease of the type 1B endoleak."