ellis3350
Guru
Hello,
I'm hoping I can get some feedback on coding the cath placements 36005-50 or 36010-50 for this procedure for an ASC setting. I'm looking at codes 37238-LT, 36010-50, 37252, 37253. Any guidance would be greatly appreciated.
Indications: venous insufficiency, abnormal pelvic CT, VCSS: 12, CEAP left: C4a, Right: C4a
Procedural details: The patient was brought to the Cath Lab in the usual fasting state and monitored using surface EKG, intravascular pressure waveforms, pulse oximetry, automatic blood pressure cuff, and end-tidal CO2 measurements. Bilateral popliteal were prepped with chlorhexidine and draped in the usual sterile fashion and the access sites were infiltrated with local anesthesia and vascular access was obtained using a modified Seldinger technique with 8 Fr sheaths inserted into the right and left popliteal veins.
Ultrasound guidance was utilized to document venous patency and to assist with obtaining venous access. Images were stored for documentation purposes.
Next, venography was performed of the right via the sheath. This was repeated on the left side via the sheath. Then, a 0.035 IVUS catheter was inserted into the right and into the distal vena cava and IVUS measurements were of the iliofemoral veins. This was repeated on the left side.
The left sheath was upsized to 10 Fr. and a 16x60 Atlas balloon was inflated across the left common iliac and left external iliac veins. Next, and Abre 18x120 stent was deployed across the left Common iliac and left external iliac vein. The 16x60 atlas balloon was then used for post dilation across the stent. IVUS was then inserted and performed in stent and measurements recorded.
Findings:
IVC-435 mm2 18x29mm
Right common iliac vein-232 mm2 16x20mm
Right external iliac vein-Reference area/dia: 237 mm2 16x18mm
Right common femoral vein-Reference area/dia 212 mm2 5x17mm
Left common iliac vein-Reference area/dia 212mm2 15x18
compress area/dia 80 mm2 7x14 mm
difference 62%
stent deployed 18x120
balloon inflated 16x60
post stenting area 234 mm2
post percent stenosis 0%
Left external iliac vein- 137mm2 10x18
Left common femoral vein-137mm2 10x18
Thanks,
Diana
I'm hoping I can get some feedback on coding the cath placements 36005-50 or 36010-50 for this procedure for an ASC setting. I'm looking at codes 37238-LT, 36010-50, 37252, 37253. Any guidance would be greatly appreciated.
Indications: venous insufficiency, abnormal pelvic CT, VCSS: 12, CEAP left: C4a, Right: C4a
Procedural details: The patient was brought to the Cath Lab in the usual fasting state and monitored using surface EKG, intravascular pressure waveforms, pulse oximetry, automatic blood pressure cuff, and end-tidal CO2 measurements. Bilateral popliteal were prepped with chlorhexidine and draped in the usual sterile fashion and the access sites were infiltrated with local anesthesia and vascular access was obtained using a modified Seldinger technique with 8 Fr sheaths inserted into the right and left popliteal veins.
Ultrasound guidance was utilized to document venous patency and to assist with obtaining venous access. Images were stored for documentation purposes.
Next, venography was performed of the right via the sheath. This was repeated on the left side via the sheath. Then, a 0.035 IVUS catheter was inserted into the right and into the distal vena cava and IVUS measurements were of the iliofemoral veins. This was repeated on the left side.
The left sheath was upsized to 10 Fr. and a 16x60 Atlas balloon was inflated across the left common iliac and left external iliac veins. Next, and Abre 18x120 stent was deployed across the left Common iliac and left external iliac vein. The 16x60 atlas balloon was then used for post dilation across the stent. IVUS was then inserted and performed in stent and measurements recorded.
Findings:
IVC-435 mm2 18x29mm
Right common iliac vein-232 mm2 16x20mm
Right external iliac vein-Reference area/dia: 237 mm2 16x18mm
Right common femoral vein-Reference area/dia 212 mm2 5x17mm
Left common iliac vein-Reference area/dia 212mm2 15x18
compress area/dia 80 mm2 7x14 mm
difference 62%
stent deployed 18x120
balloon inflated 16x60
post stenting area 234 mm2
post percent stenosis 0%
Left external iliac vein- 137mm2 10x18
Left common femoral vein-137mm2 10x18
Thanks,
Diana