Ask Dr. Z
Ask Dr. Z Knowledge Base houses over 7,500 coding questions and answers dating back to 2013.
Ask Dr. Z Disclaimer
Please note this question was answered in 2012. The coding advice may or may not be outdated.
Hepatic venous sampling after arterial infusion of calcium gluconate, visce
Date: Mar 19, 2012
Question:
Is there a code for the calcium stimulaton?
thanks!
PROCEDURE: Following informed consent, and verification of the appropriate patient identification and procedure be performed, the right groin was sterilely cleaned, prepped and draped. Local anesthesia was achieved with lidocaine 2%. Via a right common femoral vein a 5-French vascular sheath was placed. Through this a 5-French Simmons-2 catheter (modified with two extra side holes 0.5 cm from the tip) was advanced over a wire into the right hepatic vein (second order). Selective right hepatic venography was performed confirming location. Subsequently via a right common femoral artery puncture a 5-French vascular sheath was placed. Through this a 5 French RC-I catheter was advanced into the celiac artery and celiac arteriography was performed.
Subsequently the catheter was advanced to 5 super selective vessels. These included A: The distal splenic artery just proximal to the pancreaticomagna artery, B: The proximal splenic artery just proximal to the dorsal pancreatic artery, C: Proximal common hepatic artery, : The gastroduodenal artery proximal to the superior pancreaticoduodenal arcade and E: The superior mesenteric artery proximal to the inferior pancreaticoduodenal arcade. In each super selective site catheterized, selective arteriography was performed. Following selective arteriography the patient was administered calcium gluconate, 10%, 5 cc (0.025 mEq of calcium/kg) intraarterially and right hepatic venous blood samples were drawn 0 seconds, 30 seconds, 60 seconds, and 120 seconds following administration of the intraarterial calcium. This resulted in 20 samples obtained from the right hepatic vein sent for insulin level analysis. The catheters were removed and hemostasis obtained at the puncture sites.
FINDINGS: There is classic celiac anatomy. The dorsal pancreatic, pancreaticomagna, gastroduodenal artery, superior pancreaticoduodenal arcade and inferior pancreaticoduodenal arcade are normal. The superior and mesenteric artery and its branches are normal. The right hepatic venogram is normal. No hypervascular tumor was identified angiographically.
IMPRESSION: Super selective mesenteric angiography with calcium stimulation and simultaneous selective hepatic venous sampling for insulin levels.
thanks!
PROCEDURE: Following informed consent, and verification of the appropriate patient identification and procedure be performed, the right groin was sterilely cleaned, prepped and draped. Local anesthesia was achieved with lidocaine 2%. Via a right common femoral vein a 5-French vascular sheath was placed. Through this a 5-French Simmons-2 catheter (modified with two extra side holes 0.5 cm from the tip) was advanced over a wire into the right hepatic vein (second order). Selective right hepatic venography was performed confirming location. Subsequently via a right common femoral artery puncture a 5-French vascular sheath was placed. Through this a 5 French RC-I catheter was advanced into the celiac artery and celiac arteriography was performed.
Subsequently the catheter was advanced to 5 super selective vessels. These included A: The distal splenic artery just proximal to the pancreaticomagna artery, B: The proximal splenic artery just proximal to the dorsal pancreatic artery, C: Proximal common hepatic artery, : The gastroduodenal artery proximal to the superior pancreaticoduodenal arcade and E: The superior mesenteric artery proximal to the inferior pancreaticoduodenal arcade. In each super selective site catheterized, selective arteriography was performed. Following selective arteriography the patient was administered calcium gluconate, 10%, 5 cc (0.025 mEq of calcium/kg) intraarterially and right hepatic venous blood samples were drawn 0 seconds, 30 seconds, 60 seconds, and 120 seconds following administration of the intraarterial calcium. This resulted in 20 samples obtained from the right hepatic vein sent for insulin level analysis. The catheters were removed and hemostasis obtained at the puncture sites.
FINDINGS: There is classic celiac anatomy. The dorsal pancreatic, pancreaticomagna, gastroduodenal artery, superior pancreaticoduodenal arcade and inferior pancreaticoduodenal arcade are normal. The superior and mesenteric artery and its branches are normal. The right hepatic venogram is normal. No hypervascular tumor was identified angiographically.
IMPRESSION: Super selective mesenteric angiography with calcium stimulation and simultaneous selective hepatic venous sampling for insulin levels.
Need to ask Dr.Z?
Don't see the answer you're looking for in the knowledge base? No problem. You can ask Dr. Z directly!Ask Dr. Z a question now!