Hi, I'm searching for clear guidelines of when you would use 10030 vs 75989 for an aspiration or fluid drainage by catheter. I'm assuming if it is done by the IR physician then you would always choose to use 10030? Here is an example of a report. I greatly appreciate the guidance, I can't even find clear comparison in Dr. Z reference material.
The patient was brought to the suite and placed in a supine position upon
the ultrasound table. The right upper quadrant was prepped and draped in
a sterile fashion. The skin and subcutaneous soft tissue were
anesthetized using 1% buffered lidocaine. A 2 mm dermatotomy was made
using a #11 scalpel blade.
Then, using real-time ultrasound guidance, a 10 cm centesis sheathed
needle needle was advanced into the epicenter of the multiloculated
subcutaneous fluid collection. The needle was removed and the sheath was
left in place. Subsequently. The sheath was hooked to a sterile tubing
and a Vacutainer. A total of 75 cc of cloudy sanguinous fluid was removed
(previously 200 cc).
The needle was removed and local hemostasis was achieved using gentle
manual pressure. Sterile dressing was applied. At the conclusion of the
procedure a post drainage ultrasound image of the right upper quadrant
was obtained and placed in the patient's permanent record. The ultrasound
image demonstrates some residual fluid within the subcutaneous soft
tissue likely related to known septations.
The patient tolerated the procedure well without any immediate
complications. No ionizing radiation or radiopaque contrast were
administered. The estimated blood loss was less than 5 cc.
IMPRESSION:
1. Limited aspiration of the right upper quadrant subcutaneous abdominal
wall seroma due to multiple loculations using ultrasound guidance as
described above.
The patient was brought to the suite and placed in a supine position upon
the ultrasound table. The right upper quadrant was prepped and draped in
a sterile fashion. The skin and subcutaneous soft tissue were
anesthetized using 1% buffered lidocaine. A 2 mm dermatotomy was made
using a #11 scalpel blade.
Then, using real-time ultrasound guidance, a 10 cm centesis sheathed
needle needle was advanced into the epicenter of the multiloculated
subcutaneous fluid collection. The needle was removed and the sheath was
left in place. Subsequently. The sheath was hooked to a sterile tubing
and a Vacutainer. A total of 75 cc of cloudy sanguinous fluid was removed
(previously 200 cc).
The needle was removed and local hemostasis was achieved using gentle
manual pressure. Sterile dressing was applied. At the conclusion of the
procedure a post drainage ultrasound image of the right upper quadrant
was obtained and placed in the patient's permanent record. The ultrasound
image demonstrates some residual fluid within the subcutaneous soft
tissue likely related to known septations.
The patient tolerated the procedure well without any immediate
complications. No ionizing radiation or radiopaque contrast were
administered. The estimated blood loss was less than 5 cc.
IMPRESSION:
1. Limited aspiration of the right upper quadrant subcutaneous abdominal
wall seroma due to multiple loculations using ultrasound guidance as
described above.