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describe how you came about each of the seven characters that form the corresponding PCS code. Reference the operative report to support your choices. Before discussing how you went about building the PCS code, give a brief description of what the procedure entails and how it treats the medical condition stated as the pre/post diagnosis in the operative report. Need 4 pcs code DIAGNOSIS: NSTEMI PROCEDURES PERFORMED: 1. Thrombectomy of the left circumflex artery 2. Stenting angioplasty of the left circumflex artery 3. Stenting angioplasty of the LAD 4. Stenting angioplasty of the RCA 5. Coronary angiography DESCRIPTION OF PROCEDURE: The patient arrived to the cardiac catheterization lab with evidence of posterior wall myocardial infarction. The right groin was prepped in normal sterilization technique. A 6-French introducer catheter was placed in the right femoral artery using Seldinger technique. Judkins technique was used for coronary angiography. CORONARY ANGIOGRAPHY: Left main bifurcates into LAD and left circumflex. The left main is extremely short. The left circumflex is occluded. The LAD has a tight hazy-looking lesion in the range about 85%-90%. Right coronary artery is dominant with an 85% mid lesion. ANGIOPLASTY OF THE LEFT CIRCUMFLEX ARTERY: The guide was an XB 3.5 guide. I started the procedure by putting it in the left main and I started with the angioplasty immediately. The wire was pushed across the left circumflex artery, which is a very large vessel, with a huge obtuse marginal. Thrombectomy was done in the circumflex utilizing the aspiration catheter. TIMI-3 flow was established. After which, a drug-coated Xience stent was placed, achieving a 0% residual stenosis and excellent flow. After that, attention was taken into the LAD. The lesion of the LAD seems to be very proximal hazy 85%-90%. I was worried that it is a ruptured plaque. So, I kept the wire in the left circumflex artery and I advanced another wire into the LAD. I kept the wire in the left circumflex to keep anchoring the guide particularly with a very short left main, afterward direct stenting with Vision stent achieving a 0% residual stenosis and excellent TIMI-3 flow into the LAD. The right coronary was then evaluated. The lesion was in the mid RCA. The wire was pushed across and a drug-coated Xience stent was placed, achieving a 0% residual stenosis and excellent flow. All wires were removed. Final images were obtained.

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