93568 Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for pulmonary angiography (List separately in addition to code for primary procedure)

Name of the Procedure:

Pulmonary Angiography Injection during Cardiac Catheterization, including Imaging Supervision, Interpretation, and Report.

Summary

This procedure involves injecting a contrast dye into the pulmonary arteries to visualize blood flow in the lungs. It is performed during a cardiac catheterization process and includes imaging supervision, interpretation, and a comprehensive report.

Purpose

Pulmonary angiography aims to diagnose and evaluate conditions such as pulmonary embolism, congenital heart disease affecting lung blood vessels, and other vascular abnormalities in the lungs. The expected outcomes are accurate diagnosis and guidance for appropriate treatment plans.

Indications

• Suspected pulmonary embolism
• Unexplained shortness of breath
• Evaluation of congenital heart defects affecting pulmonary circulation
• Assessment of pulmonary hypertension
• Preoperative evaluation before lung surgery

Preparation

• Patients may need to fast for 6-8 hours before the procedure.
• Adjustments to medications, particularly blood thinners, may be necessary.
• Pre-procedure blood tests, ECG, and imaging studies might be required.

Procedure Description

1. The patient lies on an X-ray table, and an intravenous (IV) line is inserted.
2. Local anesthesia is applied to the insertion site, usually the groin or arm.
3. A catheter is guided through the blood vessels to the pulmonary arteries.
4. Contrast dye is injected through the catheter.
5. Real-time X-ray images (fluoroscopy) are taken to visualize blood flow.
6. The radiologist supervises, interprets the images, and prepares a detailed report.
7. The catheter is then removed, and pressure is applied to the insertion site to prevent bleeding.

Duration

The procedure typically takes about 1 to 2 hours.

Setting

Hospital cardiac catheterization lab or specialized radiology department.

Personnel

• Interventional cardiologist or radiologist
• Nurses
• Radiologic technologist
• Anesthesiologist, if sedation is necessary

Risks and Complications

Common risks:

• Pain or bruising at the catheter insertion site
• Allergic reaction to contrast dye Rare risks:
• Blood vessel damage
• Infection
• Pulmonary artery rupture
• Blood clots or embolisms Management includes prompt medical intervention and supportive care.

Benefits

• Accurate diagnosis of lung blood flow issues
• Identification of the cause of symptoms
• Guidance for effective treatment, leading to improved health outcomes Expected benefits are often realized immediately following image analysis.

Recovery

• Patients may need to rest flat for several hours post-procedure.
• Monitoring for potential complications, such as bleeding or allergic reactions.
• Follow-up visits may be scheduled to discuss results and treatment plans. Recovery time is typically short, with most patients resuming normal activities within a day.

Alternatives

• CT Pulmonary Angiography
• V/Q (Ventilation/Perfusion) scan
• MRI Pros and cons of alternatives include varying levels of invasiveness and accuracy, with some non-invasive options offering less risk but potentially lower diagnostic precision.

Patient Experience

During the procedure, patients may feel pressure at the catheter insertion site and a warm sensation as the contrast dye is administered. Post-procedure, minor soreness might be experienced, with pain managed through medication. Comfort measures include applying ice packs and ensuring rest.