AMA Clinical Examples in Radiology - 2014 Issue 1 (Winter)
Abdominal Aortogram with Aortic Stent Placement
Abdominal Aortogram with Aortic Stent Placement Clinical History Lifestyle-limiting bilateral buttock and thigh claudication. Procedure Aortogram. Balloon-expandable stent deployment in the distal abdominal aorta. Technique The patient's prior lower extremity vascular ultrasound findings were reviewed. There were no prior aortic or lower extremity angiographic studies. Informed written consent was obtained from the patient after an explanation of the risks, benefits, and alternatives to the procedure. The patient was identified, brought to the procedure room, and placed in the supine position. The patient's right groin was prepped and draped in the usual sterile fashion, and a procedural "time out" was...
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Article Overview
This article presents a radiology procedure example involving abdominal aortic imaging and stent placement, followed by a coding discussion for reporting the case in a CPT-based setting. It is aimed at coding professionals who want to compare procedural documentation with appropriate diagnostic and interventional code reporting, including related guidance on bundled services, vascular access imaging, and diagnostic angiography. The article also places the example in the context of CPT code changes effective in 2014 and references professional society and AMA materials.
Why This Topic Matters
This content helps coders and auditors understand how a vascular interventional radiology case is documented and how the related reporting framework is discussed in a premium example. It is relevant for ensuring consistent interpretation of procedure notes, diagnostic imaging, and bundled service concepts in abdominal aortic interventions.
Article Sections
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Clinical History
Summarizes the patient presentation and reason for the procedure.
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Procedure
Outlines the major steps performed during the vascular and imaging procedure.
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Technique
Describes access preparation, catheter and imaging workflow, and completion of the intervention.
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Findings
Reports the imaging and hemodynamic observations made during the case.
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How to Code
Provides the coding discussion for the documented procedure and related reporting considerations.
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Discussion
Reviews coding background, bundled service concepts, and the 2014 CPT update context.
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References
Lists source materials cited in connection with the case discussion.
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Radiology Test Case
Introduces the self-test portion of the article for coding practice.
What You Will Learn
- How a radiology vascular case is organized from clinical history through findings
- What categories of coding guidance are discussed for diagnostic and interventional reporting
- How the article frames bundled services and related documentation considerations
- The professional resources and 2014 context referenced by the case study
Who Should Read This
- Medical coders
- Coding auditors
- Radiology billing staff
- Interventional radiology professionals
- Compliance teams
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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