Thrombin/gelfoam slurry injection

[prabha]

How to code the below procedure?Can we code it as an E/M code


Procedure: Thrombin/Gelfoam slurry injection through subcutaneous
tunnel of indwelling right chest wall tunnel dialysis catheter.

The patient is status post
tunnel dialysis catheter exchange. The patient
returns with persistent and intermittent oozing from the
subcutaneous tunnel. Referred for catheter evaluation for
persistent oozing.

On physical examination, no active bleeding through the
subcutaneous tunnel is visualized, however, there is a small
amount of subcutaneous hematoma with expression of blood clot.

The right chest subcutaneous tunnel site was then prepped and
draped in usual sterile fashion. The skin and subcutaneous
tissues were anesthetized with 2% lidocaine solution. Injection
of a slurry composed of 5000 units of thrombin, normal saline
solution, and Gelfoam pledgets into the subcutaneous tunnel was
then performed. Injection was performed while simultaneously
compressing the right internal jugular vein. The skin entry site
was covered with a sterile dressing. The patient tolerated the
procedure well and left the department in stable condition.

Impression: Thrombin/Gelfoam slurry injection into subcutaneous
tunnel of indwelling right chest wall tunneled dialysis catheter,
as above.

[MLS2]

I was thinking an unlisted code for this...

[vkhusid]

Can anyone help me please...
How do we bill for Thrombin in office settings? One of our physicians did a surgery on a patient, patient had post-op bleading and came back to the office. Doctor took thrombin from ambulatory surgery and they will bill us for it. I need to know how do we bill that? Can we bill at all in post op period?

Thanks