Shirleybala
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Hi,
How to code this senario.
Preliminary ultrasound demonstrates irregularity of the left
internal and external jugular veins. The left neck was then
prepped and draped in the usual sterile manner and locally
anesthetized with two percent lidocaine. Under ultrasound
guidance, the left internal jugular vein was accessed with a
micropuncture set. The microwire would not advance below the
level of the clavicle. Subsequently, limited venography through
the needle was performed, demonstrating an occluded left internal
jugular vein with abnormal, tortuous collateral vessels at the
base of the left neck.
Subsequently, the left external jugular vein was punctured with a
21-gauge needle A permanent recording was created for the
patient's record. The microwire would not advance through the
needle. Subsequently, limited venography was performed,
demonstrating an occluded left external jugular vein. The left
neck access was then aborted.
Limited ultrasound of the right common femoral vein was then
performed, demonstrating a widely patent and freely compressible
vein. Subsequently, the right groin was prepped and draped in
usual sterile fashion. 1% lidocaine was administered for local
anesthesia. Under real-time sonographic guidance, a 21-gauge
needle was advanced into the right common femoral vein. A
sonographic recording was created for the patient's record.
Exchange was made for a micropuncture set. The tract was then
dilated over a guidewire, and a 24 cm long Schon XL non-tunneled
dialysis catheter was placed, catheter tip in the inferior vena
cava. Good bidirectional flow was noted from both lumens, which
were locked with heparin solution. The catheter was sutured in
place with prolene and a sterile dressing applied. The patient
tolerated the procedure well, and left the department in stable
condition.
How to code this senario.
Preliminary ultrasound demonstrates irregularity of the left
internal and external jugular veins. The left neck was then
prepped and draped in the usual sterile manner and locally
anesthetized with two percent lidocaine. Under ultrasound
guidance, the left internal jugular vein was accessed with a
micropuncture set. The microwire would not advance below the
level of the clavicle. Subsequently, limited venography through
the needle was performed, demonstrating an occluded left internal
jugular vein with abnormal, tortuous collateral vessels at the
base of the left neck.
Subsequently, the left external jugular vein was punctured with a
21-gauge needle A permanent recording was created for the
patient's record. The microwire would not advance through the
needle. Subsequently, limited venography was performed,
demonstrating an occluded left external jugular vein. The left
neck access was then aborted.
Limited ultrasound of the right common femoral vein was then
performed, demonstrating a widely patent and freely compressible
vein. Subsequently, the right groin was prepped and draped in
usual sterile fashion. 1% lidocaine was administered for local
anesthesia. Under real-time sonographic guidance, a 21-gauge
needle was advanced into the right common femoral vein. A
sonographic recording was created for the patient's record.
Exchange was made for a micropuncture set. The tract was then
dilated over a guidewire, and a 24 cm long Schon XL non-tunneled
dialysis catheter was placed, catheter tip in the inferior vena
cava. Good bidirectional flow was noted from both lumens, which
were locked with heparin solution. The catheter was sutured in
place with prolene and a sterile dressing applied. The patient
tolerated the procedure well, and left the department in stable
condition.