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Hi Dr. Z. Can you help us code the one below? Not sure with the new Cervicocerebral angio codes. Thank you Aortic arch and the selective left innominate artery injection Pigtail catheter and a Bentson guidewire were advanced into the descending aorta. A right-sided aortic arch was again noted. Contrast injection with AP imaging of the arch and lateral imaging of the head performed. Multiple catheters were then utilized in attempts to catheterize the aberrant innominate artery including DAV catheter, Headhunter catheter, JB2 catheter, angled pigtail catheter, and a Newton 5 catheter. Successful placement and imaging was performed with a Vert catheter placed over a Bentson wire. J-wire, Bentson wire, and a glide wires were utilized. Following demonstration of stenosis of the origin of left common carotid artery from the aberrant innominate artery, the procedure was ended and sheath was withdrawn with closure device placement. Findings: Right-sided arch with aberrant innominate artery. Selective catheterization included the innominate artery. The examination shows a high-grade stenosis at the origin of the left common carotid artery from the aberrant innominate artery best demonstrated with Vert catheter placed into the distal innominate artery. Subclavian artery on the left was open as well as the left vertebral artery. Since there was a diagnostic CT angiogram, further catheter manipulation in the arch was thought unneeded arch injection showed open right common carotid artery and right subclavian artery without origin stenosis. Right vertebral artery was open and large.