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Balloon Tamponade of Perforated Inferior Epigastric Artery

Date: Sep 18, 2014

Question:

"Complications: After completion of left heart catheterization, a right iliac angiogram was done for closure device deployment. A small perforation was noted from needle stick in the inferior epigastric artery, which was successfully sealed off/tamponade by 7.0 x 20 Mustang over the wire balloon, with two inflations of 10 min at nominal pressures. Angiogram was repeated, which showed normal inferior epigastric artery with extravasation of contrast." This was recently performed in the heart cath lab. My question is how would you code this to reflect the procedure performed? The first iliac angio was done for closure device evaluation. The second was done to evaluate the perforation. A balloon was used to seal the perforation until hemostasis was achieved. I spoke with the cardiologist, and the balloon was inflated in the femoral/iliac artery area, and at no time did he enter the epigastric artery. Are codes 36245, 75710, and 37244 appropriate?

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