Answer Happy

1. Write a 2-3 page paper (600-800 words) based on Principle Diagnosis #25 found on page 174 of your workbook. (Chapter 17, page 93-98 in the workbook) 2. Find the CPT and ICD-10-CMS Codes and include your reasoning for choosing the codes you used. 3. Present your answers, the codes, but walk the reader through the reasoning and justification of those codes in essay style.
25. CARDIAC CATHETERIZATION REPORT PROCEDURES PERFORMED: Left-sided heart catheterization, selective coronary angiography, and left ventriculography. INDICATION: Chest pain and abnormal Cardiolite stress test. COMPLICATIONS: None. RESULTS: I. HEMODYNAMICS: The left ventricular pressure before the LV-gram was 117/1 with an LVEDP of 4. After the LV-gram, it was 111/4 with an LVEDP of 10. The aortic pressure on pullback was 111/17. II. LEFT VENTRICULOGRAPHY: The left ventriculography showed that the left ventricle was of normal size. There were no significant segmental wall motion abnormalities. The overall left ventricular systolic function was normal with an ejection fraction of better than 60%.
APPENDIX A Reports III. SELECTIVE CORONARY ANGIOGRAPHY: A. RIGHT CORONARY ARTERY: The right coronary artery is a medium to large size dominant artery that has about 80% to 90% proximal/mid eccentric stenosis. The rest of the artery has only mild surface irregularities. The PDA and the posterolateral branches are small in size and have only mild surface irregularities. B. LEFT MAIN CORONARY ARTERY: The left main has mild distal narrowing. C. LEFT CIRCUMFLEX ARTERY: The left circumflex artery was a medium size, nondominant artery. It gave rise to a very high first obtuse marginal/intermedius, which was a bifurcating medium size artery that has only mild surface irregularities. The second obtuse marginal was also a medium size artery that has about 20% to 25% proximal narrowing. After that second obtuse marginal, the circumflex artery was a small size artery that has about 20% to 30% narrowing, a small aneurysmal segment. After that, it continued as a small third obtuse marginal that has mild atherosclerotic disease. D. LEFT ANTERIOR DESCENDING CORONARY ARTERY: The left anterior descending artery was a medium size artery that is mildly calcified. It gave rise to a very tiny first diagonal that has mild diffuse atherosclerotic disease. Right at the origin of the second diagonal, the LAD has about 30% narrowing. The rest of the artery was free of significant obstructive disease. The second diagonal was also a small caliber artery that has no significant obstructive disease. CONCLUSION: 1. Normal overall left ventricular systolic function 2. Severe single vessel atherosclerotic heart disease RECOMMENDATIONS: Angioplasty stent of the right coronary artery.