[Answered]: ICD 10 PCS OTE: Do not code Imaging on this case

ICD 10 PCS OTE: Do not code Imaging on this case. PREOPERATIVE DIAGNOSIS: Right peripheral artery disease with ulcer POSTOPERATIVE DIAGNOSIS: Same OPERATION PERFORMED: 1. Ultrasound guided access of left common femoral artery 2. Aortogram with right leg runoff 3. Revascularization of the posterior tibial artery using a 3×200 mm balloon and Esprit resorbable scaffold 4. Revascularization of popliteal artery with 5.5 shockwave balloon followed by 6×120 mm drug coated balloon FINDINGS: 1. Aortogram demonstrating patent aorto-iliac segments 2. Calcified stenosis of above knee popliteal resolved with IVL, PTA with DCB 3. Posterior tibial artery – focal stenosis at mid PT resolved with PTA and Everolimus-eluting scaffold INDICATIONS FOR PROCEDURE: Patient with right leg peripheral artery disease and wound. Patient was offered right leg angiogram with possible intervention. Risks and benefits of procedure were explained to the patient. Consent was signed. DESCRIPTION OF PROCEDURE: The patient was brought into the operating room and placed in supine position. Bilateral groins were prepped. Under local MAC, appropriate lines and monitors were placed. Preoperative antibiotics were given and a timeout was performed. I used ultrasound to identify the patient’s anatomy. A micro-puncture needle was inserted into the left common femoral artery using ultrasound. A 5-French sheath was inserted and an aortogram was performed through an omni-flush catheter with the findings noted above. I then went up and over the aortic bifurcation and performed a right leg angiogram with the findings noted above. A 6×45 cm sheath was advanced over a Bentson wire. Heparin was given. I cannulated past the area of stenosis using a glide wire and glide catheter. I then selected the selected the posterior tibial artery. I performed balloon angioplasty with a 3×200 mm balloon. I then placed an Esprit resorbable scaffold and dilated with a 3×200 mm balloon. This resolved the stenosis. I then performed shockwave PTA at the above-knee popliteal artery delivering 300 shocks. I then used a 6×120 mm drug-coated balloon and held this for 3 minutes at 8 atm. This resolved the stenosis. All wires and catheters and sheaths were removed. A Perclose device was used to close the puncture site. Manual pressure was held. A Monocryl suture was used to close the puncture site. A sterile occlusive dressing was placed. The patient tolerated the procedure well and was brought to PACU in stable condition.