Wiki 36010

Shirleybala

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Hi,
In this senario should i have to code 36010 twice with a 59 modifier, please advice.

Preliminary ultrasound of the left groin was performed
demonstrating patency of the left common femoral vein. The
patient's left groin was prepped and draped in the usual sterile
manner and locally anesthetized with 1 percent lidocaine. The
left common femoral vein was accessed with a micropuncture set.
Limited venography was performed confirming patency of the left
common iliac vein. An omni flush catheter was then passed into
the inferior vena cava. Contrast was injected and digital
subtraction venography was performed of the inferior vena cava.


Findings:

There is thrombus within the inferior vena cava. Normal venous
anatomy is identified. Renal vein inflow is identified
bilaterally. The IVC is of normal caliber.

At this point the left common femoral vein access was abandoned
and ultrasound was performed of the right internal jugular vein,
demonstrating patency. The right neck was prepped and draped in
the usual sterile manner and locally anesthetized with 1%
lidocaine. The right internal jugular vein was accessed with a
micropuncture set, under real-time ultrasound guidance
. A
sonographic recording was made for patient's medical record. An
Omni flush catheter was then advanced into the inferior vena cava.
Contrast was injected and digital subtraction venography was
performed of the inferior vena cava.

Findings: Again note is made of thrombus within the inferior vena
cava. Normal venous anatomy is identified. Renal vein inflow is
identified bilaterally. The IVC is of normal caliber.

The puncture site was dilated, and a Gunther Tulip introducer
sheath was placed. The Gunther Tulip IVC filter was then deployed
below the level of the renal veins. Completion venography was
performed, confirming filter position below the renal veins and
above the thrombus.
 
I would say yes also because it was done from 2 separate access sites and you code for the furthest the catheter went in each instance.
 
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