Andy I would include data fields for repeating the PSVs of celiac trunk with the patient upright if MALC is indicated by supine results. You should see a normalization of the velocities in the upright position. If so, it rules out a fixed stenosis. Perhaps a check box to indicate abnormal (fish hook) geometry of the celiac. It’s highly controversial but some feel that compression of the nerve plexus may have as much or more to do with symptoms as the artery. Giving somebody a heads up about the atypical bend may give somebody an “aha” moment about symptoms. The MALC patients are often at wits end by the time they get kicked around as far as a vascular lab.
Noting direction of flow of the hepatic may be useful. Retrograde hepatic artery flow correlates highly with CA occlusion or tight stenosis (I can give you a reference).
Include one of the central veins (recommend SMV at least) so that you can optimize your billing codes. As long as you do your complete documented mesenteric exam protocol you should be good to bill 93975.
Steve Knight | Assistant Technical Director
Vascular Ultrasound Core Lab | VasCore Training and Education Center
Massachusetts General Hospital
1 Bowdoin Square, 10th Floor | Boston | MA | 02114
Find us on LinkedIn
CONFIDENTIALITY NOTICE: This email contains information from the sender that may be confidential, legally privileged, proprietary or otherwise protected from disclosure. This email is intended for use only by the person or entity to whom it is addressed. If you are not the intended recipient, any use, disclosure, copying, distribution, printing, or any action taken in reliance on the contents of this email, is strictly prohibited. If you received this email in error, please contact the sending party by replying in an email to the sender, delete the email from your computer system and destroy any paper copies of the printed email.
External Email - Use Caution
Good morning Flownetters:
I would like to 'update' our Mesenteric template where we enter our findings after doing one of these studies. Would you please share your protocol/template for this study. It typically includes velocity data for aortic velocity near the SMA/renal, SMA, IMA, celiac axis, splenic, and common hepatic. Also inhal/exhalation for arcuate ligament compression if indicated. What else do we need?
Andy Bebry, RVT
To unsubscribe or search other topics on UVM Flownet link to: http://list.uvm.edu/archives/uvmflownet.html
The information in this e-mail is intended only for the person to whom it is
addressed. If you believe this e-mail was sent to you in error and the e-mail
contains patient information, please contact the Partners Compliance HelpLine at
http://www.partners.org/complianceline . If the e-mail was sent to you in error
but does not contain patient information, please contact the sender and properly
dispose of the e-mail.