Wiki Portal Pressure Measurement CPT Coding

[djrice86]

Hi All,

What code(s) are you using for "portal pressure measurement" to assess for portal hypertension? I've been using 93770 (Determination of venous pressure); however, some are using 36481 with 75855.

Thanks for your input.

 

[danteeg65]

Hello there, it all depends on what the case documentation states.
However for what yp ur describing your partially correct we would code
36481, and 75885 for this case.
Diagnostic Portography for diagnosis of Portal Vein hypertension is typically performed via Percutaneous Transhepatic Portography hemodynamic evaluation with wedged pressure measurements etc we would code the catheter placement with 36481- Percutaneous Portal Vein Catheterization.
75885- Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation
A Selective Hepatic Veno gram may also be performed to diagnosis and measure portal vein pressures, don't get them confused if the physician selectively accesses the Hepatic vein(s) and performs wedged or free Hepatic Venography with wedged pressure measurements we instead code
36012- 2nd order or higher catheterization, vein.
75889-Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation

Always remember dont confuse Hepatic venography and Portal Vein catheterization code 36481 is non selective and the Portal Vein is directly accessed by insertion of a needle from the skin through the liver with contrast injection and then puncture into portal vein and finally place the catheter from that access.

 

[djrice86]

Hello there, it all depends on what the case documentation states.
However for what yp ur describing your partially correct we would code
36481, and 75885 for this case.
Diagnostic Portography for diagnosis of Portal Vein hypertension is typically performed via Percutaneous Transhepatic Portography hemodynamic evaluation with wedged pressure measurements etc we would code the catheter placement with 36481- Percutaneous Portal Vein Catheterization.
75885- Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation
A Selective Hepatic Veno gram may also be performed to diagnosis and measure portal vein pressures, don't get them confused if the physician selectively accesses the Hepatic vein(s) and performs wedged or free Hepatic Venography with wedged pressure measurements we instead code
36012- 2nd order or higher catheterization, vein.
75889-Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation

Always remember dont confuse Hepatic venography and Portal Vein catheterization code 36481 is non selective and the Portal Vein is directly accessed by insertion of a needle from the skin through the liver with contrast injection and then puncture into portal vein and finally place the catheter from that access.

Thanks. Why isn't 93770 (Determination of Venous Pressure) used in this case?

 

[danteeg65]

Thanks. Why isn't 93770 (Determination of Venous Pressure) used in this case?

Depends on the documentation and what procedure is actually performed. I would look at the documentation guidelines for 93770.
For Portal Vein pressure measurements in particular 36481 and 75885 are correct for the diagnosis and measurement of "Portal Vein Hypertension".