AMA Clinical Examples in Radiology - 2014 Issue 1 (Winter)
Pelvic Angiogram with Left Internal Iliac Artery Embolization
Pelvic Angiogram with Left Internal Iliac Artery Embolization Clinical History Postpartum hemorrhage. Patient is hypotensive and tachycardic on pressors. Procedure Pelvic angiogram with left internal iliac artery embolization. Technique Verbal consent from the patient's husband was obtained. Risk regarding infection, bleeding, vascular injury, and non-target embolization versus the benefit of emergent angiography with possible embolization was discussed. A procedural "time out" was performed. Moderate sedation was utilized during this procedure. The patient received benzodiazepines and/ or opioids, the dosing of which is documented in the patient's permanent medical record. Pre-sedation history and evaluation revealed no contraindications to sedation. The...
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Article Overview
This article is a coding-oriented clinical example centered on emergent pelvic angiography and embolization for postpartum hemorrhage. It reviews the procedure context, related diagnostic imaging and access guidance, and the general reporting considerations that affect how the case is coded in CPT and Category II code sets. The discussion is intended for medical coders, radiology billing staff, and clinicians who document interventional radiology procedures.
Why This Topic Matters
It helps readers identify the relevant interventional radiology services documented in a complex hemorrhage case and understand how accompanying imaging, vascular access, and quality-reporting elements are addressed in coding guidance.
Article Sections
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Clinical History
Brief patient context and the clinical situation prompting the interventional radiology procedure.
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Procedure
A short overview of the main pelvic angiography and embolization service performed.
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Technique
Narrative procedural details describing access, catheter use, angiographic assessment, embolization, and completion of the intervention.
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Findings
Summary of the angiographic observations and the overall procedural result.
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How to Code
Coding guidance for the procedure, including related imaging, catheterization, ultrasound access guidance, and quality-reporting references.
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Discussion
Expanded coding discussion covering embolization reporting concepts, diagnostic angiography considerations, access guidance documentation, and fluoroscopy reporting in a quality program context.
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References
Source citations and supporting reference materials used in the article.
What You Will Learn
- How the case is framed as an interventional radiology coding example
- Which general procedure components are discussed in relation to reporting
- How the article addresses accompanying imaging and access-related services
- What broader coding topics are covered in the discussion section
- How fluoroscopy documentation is tied to quality-reporting context
Who Should Read This
- Medical coders
- Interventional radiology billing staff
- Radiology documentation specialists
- Physicians documenting procedural services
- Compliance and quality-reporting staff
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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