neelaprakash
Networker
- Messages
- 25
- Best answers
- 0
LEFT BILIARY DRAIN:
Diluted contrast was slowly injected through the right biliary drain, obtaining a cholangiogram.
LEFT CHOLANGIOGRAM: The tip is within the small bowel. The intra and extrahepatic biliary ducts opacified contrast with contrast passing into the small bowel.
RIGHT BILIARY DRAIN:
Diluted contrast was slowly injected through the right biliary drain, obtaining a cholangiogram.
RIGHT CHOLANGIOGRAM: The tip is within the small bowel. The intra and extrahepatic biliary ducts opacified contrast with contrast passing into the small bowel.
A J-wire was advanced through the existing percutaneous biliary drains and into the small bowel. The drains were removed and a 12 French sheath was placed on the left and a 9 French sheath was placed on the right. Simultaneous over-the-wire cholangiograms were then performed through both sheaths.
SIMULTANEOUS RIGHT AND LEFT CHOLANGIOGRAMS There is filling defect within the main left biliary duct with reflux of contrast into the segmental ducts. There is also a small filling defect within the right biliary duct that spontaneously clears.
LEFT BILIARY DUCT ABLATION: A spy glass was then advanced over the wire through the left sided sheath which was used to evaluate the site of stricture. Next an RFA probe was advanced over the wire to the site of narrowing and ablation was performed along the length of the stricture in 90 second ablation time. Next 7 mm, 10 mm mustang balloons as well as a a 6 French Fogarty balloon were sequentially advanced into the site of ablation and used to sweep away any debris. Next, the sheath was removed and a 16 Fr biliary drain was placed on the left and a 12 Fr biliary drain was placed on the right. The wire was removed and the pigtail was formed. Injection of diluted contrast confirmed appropriate positioning. The percutaneous drains were secured to the skin and a sterile dressing applied. The catheters were placed to bag drainage.
This is what the coders coded.
47536 - 50
47499
I am thinking - we should be coding 47382 instead of 47499.
TIA
Diluted contrast was slowly injected through the right biliary drain, obtaining a cholangiogram.
LEFT CHOLANGIOGRAM: The tip is within the small bowel. The intra and extrahepatic biliary ducts opacified contrast with contrast passing into the small bowel.
RIGHT BILIARY DRAIN:
Diluted contrast was slowly injected through the right biliary drain, obtaining a cholangiogram.
RIGHT CHOLANGIOGRAM: The tip is within the small bowel. The intra and extrahepatic biliary ducts opacified contrast with contrast passing into the small bowel.
A J-wire was advanced through the existing percutaneous biliary drains and into the small bowel. The drains were removed and a 12 French sheath was placed on the left and a 9 French sheath was placed on the right. Simultaneous over-the-wire cholangiograms were then performed through both sheaths.
SIMULTANEOUS RIGHT AND LEFT CHOLANGIOGRAMS There is filling defect within the main left biliary duct with reflux of contrast into the segmental ducts. There is also a small filling defect within the right biliary duct that spontaneously clears.
LEFT BILIARY DUCT ABLATION: A spy glass was then advanced over the wire through the left sided sheath which was used to evaluate the site of stricture. Next an RFA probe was advanced over the wire to the site of narrowing and ablation was performed along the length of the stricture in 90 second ablation time. Next 7 mm, 10 mm mustang balloons as well as a a 6 French Fogarty balloon were sequentially advanced into the site of ablation and used to sweep away any debris. Next, the sheath was removed and a 16 Fr biliary drain was placed on the left and a 12 Fr biliary drain was placed on the right. The wire was removed and the pigtail was formed. Injection of diluted contrast confirmed appropriate positioning. The percutaneous drains were secured to the skin and a sterile dressing applied. The catheters were placed to bag drainage.
This is what the coders coded.
47536 - 50
47499
I am thinking - we should be coding 47382 instead of 47499.
TIA
