IT pump FAV emergency valve reset under fluoroscopy

alannae

Networker
Messages
94
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0
I need insight from some experts! What would you do with this?



Pt. in today for pump check and possible scheduling of replacement. The pump has had volume discrepancies showing that no medication is being delivered despite catheter dye study that was normal. Patient here today for exam under fluoroscopy and check of the emergency flow valve that will close if the pump is in jeopardy.
Patient brought to the procedure room and placed in prone position. Exam under fluoroscopy done which reveals that the FAV valve is indeed closed. Patient prepped with chloraprep and draped with sterile towels. Pump accessed and drained. 19.5 cc drained. 15.75 expected. Then a 0.12 mg bolus programmed to run for 2 minutes after pump emptied of all medication. Pump reservoir re-accessed and negative pressure held for 1 minute to reset the valve. Exam under fluoroscopy repeated which showed that the procedure was successful and that the valve was reset. Programmed another bolus of 0.3 mg to actually provide the patient with relief. After the bolus, the valve remained in the open position. This should solve her problem. Will reduce basal rate on pump since she has been without therapy and her tolerance has increased.
The recent MVA was likely the cause of her pump failure since the accident and caused the FAV valve to close. The sudden force on the pump caused the emergency valve to close. It is fortunate that it was able to be reset without replacement of the pump.

TIA
 

LisaAlonso23

Expert
Messages
363
Location
Sherman, TX
Best answers
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I need insight from some experts! What would you do with this?



Pt. in today for pump check and possible scheduling of replacement. The pump has had volume discrepancies showing that no medication is being delivered despite catheter dye study that was normal. Patient here today for exam under fluoroscopy and check of the emergency flow valve that will close if the pump is in jeopardy.
Patient brought to the procedure room and placed in prone position. Exam under fluoroscopy done which reveals that the FAV valve is indeed closed. Patient prepped with chloraprep and draped with sterile towels. Pump accessed and drained. 19.5 cc drained. 15.75 expected. Then a 0.12 mg bolus programmed to run for 2 minutes after pump emptied of all medication. Pump reservoir re-accessed and negative pressure held for 1 minute to reset the valve. Exam under fluoroscopy repeated which showed that the procedure was successful and that the valve was reset. Programmed another bolus of 0.3 mg to actually provide the patient with relief. After the bolus, the valve remained in the open position. This should solve her problem. Will reduce basal rate on pump since she has been without therapy and her tolerance has increased.
The recent MVA was likely the cause of her pump failure since the accident and caused the FAV valve to close. The sudden force on the pump caused the emergency valve to close. It is fortunate that it was able to be reset without replacement of the pump.

TIA
I would look at 62369 or 62370.
 

alannae

Networker
Messages
94
Best answers
0
Yes, I will be billing a 62370 but I'm wondering about the additional time and work of resetting the FAV valve and the examination under fluoro. That is not part of the standard pump fill process. Is there any way other that an NOC code to account for that? Or should it be considered part of the pump fill?
 
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