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Help with peritoneal port and chest port

chembree

Guru
Messages
241
Location
Dallas, GA
Best answers
0
INDICATION: Malfunction of peritoneal port, pain with chemotherapy
administration and CT findings of possible occlusion of peritoneal port
distal aspect.

After written informed consent was obtained and under sterile
conditions, after administration of local anesthetic, the peritoneal
port was accessed under fluoroscopic guidance with a 19-gauge Huber
needle. Contrast was administered. With hand-injection of contrast,
there was filling of the peritoneal space outlining loops of bowel
within the left lower quadrant, tracking laterally and superiorly with
time, and a volume of 40 mL being administered of diluted contrast and
saline. There was minimal backtracking of contrast along the sidewall of
the port seen to occur with moderate forceful injection. With slow
injection, there was dispersion of the contrast throughout the
peritoneal cavity which over time out to 10 minutes dispersed normally
without persistence of contrast at the catheter tip. The entirety of
the catheter lumen is patent.

Catheter was then loaded with 100 units/mL of heparin.

After discussion with infusion nurse, I was asked also to confirm
patency and function of chest port. Fluoroscopic evaluation revealed no
evidence of kinking in the tip of the port overlying the SVC just
proximal to the right atrium in good location. The left chest port was
accessed under sterile conditions after administration of local
anesthetic with a 19-gauge Huber needle. Contrast was administered
demonstrating patency of the port lumen and rapid flow into the SVC
without hindrance. There is no evidence of fibrin sheath. Blood could be
aspirated from the port repeatedly. The port was then loaded with 100
units/mL heparin and Huber needle withdrawn. The patient tolerated the
procedure well.

The patient did receive IV Versed and fentanyl given intravenously for a
total of 30 minutes.

IMPRESSION:

Peritoneal port is functional with normal dispersion of injected
material throughout the peritoneum, demonstrated without evidence of
seroma at the tip of the catheter nor blockage of the catheter.
Administration of chemotherapy via gravity should work well.

Left chest port in place and functional without evidence of
complication. Blood could be aspirated. Catheter tip is in good
location.



I have looked at codes 49427 and 78291 but this does not say anything about being venous related and I have also looked at 49424 and 76080 but this was not done to evalute abscess or cyct.... can anyone offer any help?
 

chembree

Guru
Messages
241
Location
Dallas, GA
Best answers
0
Hi,
peritoneal catheter injection-49424,76080
port injection-36598
Do you think 49424 and 76080 is still appropriate even though it was not done to evalute an abscess or cyct?

I can't find much guidance for these codes other than what is printed in the CPT book.


Thanks
Christy, CPC
 
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