Wiki Proper Hepatic and Right Hepatic Cath

jas0426

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Theoretical question....if cath is done through Celiac, Common Hepatic, Proper Hepatic, and Right Hepatic would you code 36247 or 36247 and 36248 since both the Proper Hepatic and Right Hepatic are third order?

Thanks!
Jeni
 
I would code the 36247 and 36248. because, they are separate and distinct branches within the same family of vessels. (Celiac Family). And the work it takes to move the cath from the Proper hepatic and then selectively cath the Righ Hepatic.

Hope that helps.
 
Theoretical question....if cath is done through Celiac, Common Hepatic, Proper Hepatic, and Right Hepatic would you code 36247 or 36247 and 36248 since both the Proper Hepatic and Right Hepatic are third order?

Thanks!
Jeni

Code only 36247 unless there is anomalous anatomy.
These are not separate branches - you have to go through the proper hepatic to get to the right hepatic, just like you've had to go through the celiac, and common hepatic.
An example of separate branches is the right and left hepatic - they branch from the proper and if both right and left hepatic are catheterized you would code 36247 and 36248. But fo proper hepatic and right hepatic, you only code the farthest.
Remember, 36247 isn't just 3rd order, it is 3rd order or higher.
 
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