Ask Dr. Z

Does this support code 93459? I don't see the graft selectively engaged.

"Under direct US guidance, access was obtained to the right common femoral artery with a micropuncture needle and micropuncture wire, and then a micropuncture sheath was placed. After that, it was upgraded over a J-wire to a 5 French sheath, and initially a JL4 catheter was used. We were unable to engage the left main coronary artery ostium. That catheter was replaced with a JL5 catheter, which was then engaged into left main coronary artery ostium. Multiple angiograms of left coronary systems were done. That catheter was then removed. Right coronary angiogram was performed with a JR4 catheter. Saphenous vein graft angiogram x2 was performed with that catheter, and the same catheter was used to place the catheter in the left subclavian artery. Over an exchange length wire, that catheter was replaced with a LIMA 5 French catheter, and left internal mammary artery angiogram was performed. Then, I went in with a pigtail catheter, and left heart cardiac catheterization was done."