Picc Line

Shirleybala

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Hi,
Can you suggest me how to code this senario, brachial vein puncture venography done,basilic vein puncture, cephalic vein puncture picc line was placed.All are done in Right side only.
Do we have to code separately or we have to code only picc line.

Under real time ultrasound guidance, the medial right brachial
vein was punctured with a 21 gauge needle.
A 0.018 inch
guidewire was inserted although the wire could not be advanced
without resistance. Contrast injection with limited venography
was performed demonstrating extravasation.

An additional 8cc of intravenous contrast was administered
peripherally on the right after which unsuccessful flouroscopic
guided needle access was attempted in the right basilic vein.

Ultrasound-guided right cephalic vein access was then successfully
attempted after administration of subcutaneous lidocaine. Through
the 21 gauge needle, a 0.018 inch guidewire was inserted. A 6
French triple lumen power PICC SOLO catheter was inserted through
the peel-away sheath and advanced to the chest. The catheter tip
was positioned at the junction of the superior vena cava and the
right atrium.
 

Shirleybala

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Suggestion

Hi mindys please give your suggestion for the above senario

Thanks
Shirley CPC, CPC-H
 

MLS2

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36569: Insertion of peripherally inserted central venous catheter (PICC), without subcutaneous port or pump; age 5 years or older

(if the pt. is 5 or older)

I didn't see mention of any US images being permanently recorded, so I wouldn't do the 76937.
 

Shirleybala

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The physician has attempted in brachial vein an venography don know we will code a 36005 with PICC
 

Hariharan

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Hi,

As per documentation I go with 36569,36005-59 and 75820 for brachial and cepahalic veins respecitively,I will not code for basilic vein attempted procedure,since there is much more documentation to support to use 36005.
 
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