Central lines

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These will be the death of me.

I know there are several factors that come into play with these things: Central or peripheral? Tunneled or nontunneled? Patient age? With or without port or pump?

I can differentiate the central or peripheral and obviously the patient age.

I'm not understanding the tunneled versus nontunneled, and without or with port or pump.

Here is my op note from today:

Right side of the neck was prepped and draped. Using ultrasound, I found the location of the right IJ. (First unsuccessful attempt through right internal jugular) (Second unsuccessful attempt through right external jugular) A third attempt was made with the IJ which proved to be successful. The dilator was then utilized over the guidewire after proper placement was documented by x-ray. The guidewire was withdrawn about 10 cm after taking the x-ray in order to have it appropriately in the SVC. The triple-lumen catheter was then inserted successfully and documented to be properly placed with another x-ray and with no evidence of pneumothorax. Catheter was sutured to the skin and covered with a sterile dressing. The patient tolerated the procedure well.

To me, this looks like a centrally inserted catheter only but tunneled or nontunneled? 36556 is my code, right? 76937-26 for the use of the ultrasound guidance?

Thank you!


Fort Walton
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Tunneled cvc should have mention of tunneled in the report. Port placement will mention a pocket and port in the dictation. I would code non tunneled.