Shirleybala
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Hi,
can i use these for the below report please suggest me
CPT
36597
36598
CV CATHETER INJECT/CHECK, TIP
Patient is a 63-year-old woman with history of breast cancer
status post placement of right IJ chest wall port on 7/20/08.
Infusion therapy unable to access port. Request for evaluation
Procedure:
The risks, benefits and alternatives to the procedure were
explained to the patient. The patient's son was present during
the consent process. The patient agreed and signed informed
consent. The patient was placed on the angiography table in the
supine position. Fluoroscopic evaluation of the chest revealed
the port reservoir to be malpositioned and flipped. Catheter tip
is seen overlying the superior vena cava with catheter extending
high into the right internal jugular vein. Utilizing manual
manipulation the port was repositioned appropriately in the
upright position. During this maneuver however the catheter
component became looped within the subcutaneous tissues.
Additional manipulations was performed with an loop largely being
corrected but residual curved noted in the subcutaneous tissues.
Catheter remained high into the internal jugular vein with tip
overlying the superior vena cava. The reservoir was then accessed
using sterile technique. There was only poor aspiration of blood
however instillation of contrast material demonstrated wide
patency of the port reservoir and catheter with flow of contrast
seen into the superior vena cava and right atrium. There was no
extravasation of contrast material. It was decided to discontinue
additional manipulations at this time. The port reservoir was
left accessed for infusion therapy. The infusion therapy
department was contacted regarding the results of this procedure.
Impression:
Patient presented with malpositioning of port reservoir. Port
reservoir was readjusted into appropriate upright position.
During this maneuver however catheter portion of the port became
somewhat coiled in the subcutaneous tissues. Port patency however
was maintained with tip over the superior vena cava.
Plan: Patient to have chemotherapy today. Patient to return in
one week for chemotherapy. If continued difficulty with
aspiration of blood remains attempts at repositioning catheter
may be warranted. If this fails to resolve the problem placement
of alternate port via the left IJ may
can i use these for the below report please suggest me
CPT
36597
36598
CV CATHETER INJECT/CHECK, TIP
Patient is a 63-year-old woman with history of breast cancer
status post placement of right IJ chest wall port on 7/20/08.
Infusion therapy unable to access port. Request for evaluation
Procedure:
The risks, benefits and alternatives to the procedure were
explained to the patient. The patient's son was present during
the consent process. The patient agreed and signed informed
consent. The patient was placed on the angiography table in the
supine position. Fluoroscopic evaluation of the chest revealed
the port reservoir to be malpositioned and flipped. Catheter tip
is seen overlying the superior vena cava with catheter extending
high into the right internal jugular vein. Utilizing manual
manipulation the port was repositioned appropriately in the
upright position. During this maneuver however the catheter
component became looped within the subcutaneous tissues.
Additional manipulations was performed with an loop largely being
corrected but residual curved noted in the subcutaneous tissues.
Catheter remained high into the internal jugular vein with tip
overlying the superior vena cava. The reservoir was then accessed
using sterile technique. There was only poor aspiration of blood
however instillation of contrast material demonstrated wide
patency of the port reservoir and catheter with flow of contrast
seen into the superior vena cava and right atrium. There was no
extravasation of contrast material. It was decided to discontinue
additional manipulations at this time. The port reservoir was
left accessed for infusion therapy. The infusion therapy
department was contacted regarding the results of this procedure.
Impression:
Patient presented with malpositioning of port reservoir. Port
reservoir was readjusted into appropriate upright position.
During this maneuver however catheter portion of the port became
somewhat coiled in the subcutaneous tissues. Port patency however
was maintained with tip over the superior vena cava.
Plan: Patient to have chemotherapy today. Patient to return in
one week for chemotherapy. If continued difficulty with
aspiration of blood remains attempts at repositioning catheter
may be warranted. If this fails to resolve the problem placement
of alternate port via the left IJ may