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The diagnosis codes are a bit tricky.  We use 414.0 atherosclerosis of coronary
arteries since the patients have coronary artery disease.  Again, we had to
educate our insurance folks as to why we were using this code.  Many of our
patients are normal and really don't present with any finger/hand/arm symptoms.

______________________________ Reply Separator _________________________________
Subject: Radial artery harvest
Author:  UVM Flownet <[log in to unmask]> at Internet-Mail
Date:    12/22/98 1:59 PM


Anne Marie,  thank you for your reply.  What diagnostic code do you use?
Often these patients are normal.  Yesterday I detected an incomplete palmer
arch.  I used the code for  stricture of artery(447.1).  We'll see if that
is rejected.

Krista Smith,  radial artery harvest is relatively new to our cardiothoracic
group.  We have devised a modified Allen's test.  In addition to our
standard upper extremity evaluation, we take PPG waveforms of the 1st, 3rd
and 5th digits with and without compression of the radial and ulnar arteries
bilaterally to asses the patency of the arch.  Then we derive finger
pressures under the same conditions.

Steve Knight
Fletcher Allen Health Care


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Date:    Mon, 21 Dec 1998 14:55:21 EST
From:    Ann Marie Kupinski <[log in to unmask]>
Subject: Re: ICD9 code for Allen's test

     We use 93923 for our PVRs that we record at rest and during radial
     artery compression.  We use 93931 for a limited upper extremity duplex
     scan of the radial and ulnar arteries.

     Ann Marie

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Date:    Mon, 21 Dec 1998 19:02:15 -0600
From:    Krista Smith <[log in to unmask]>
Subject: Re: ICD9 code for Allen's test

To those of you who do radial artery exams for harvest frequently, would
you be willing to share your scan protocol and wisdom?

 I was recently performing an exam on  a patient for radial artery harvest.
The physician had ordered an ue sap and allens test which were normal. This
was the first request I had received for this purpose, so I didn't have a
protocol to follow. Something (maybe a guardian angel!?) made me go ahead
and perform a duplex exam even though the indirect was normal.  The patient
had a single artery through the forearm which bifurcated  to a radial and
ulnar approx. 4-5 cm proximal to the wrist. Is this a common anomaly? I
have never seen it before.

Krista Smith, RDMS, RVT