margaret fahy
Guru
Hey Folks,
Exactly which codes would
you use for the venogram and catheter placement prior to 37212?
Preliminary lower IVC sonography finds no IVC clot. The patient
was placed prone on the x-ray table and an ultrasound of the left
popliteal vein was performed . A suitable skin site was marked.
The popliteal fossa was prepared and draped in the usual sterile
fashion. Using ultrasound guidance a 21 gauge needle puncture
needle was advanced into the left popliteal vein and a 0.018
Mandril wire was advanced under fluoroscopic guidance. A 5 French
micropuncture dilator was then inserted and 0.018 inch Mandril
was exchanged for a 0.035 inch Glidewire and a 7F vascular sheath
was placed. Using a JB-1 catheter and the glidewire the catheter
was manipulated into the distal IVC and contrast was injected
demonstrating a patent IVC. The JB-1 catheter was then withdrawn
to the level of the left common iliac vein and injected
demonstrating nonocclusive thrombus at this level. A 5F 90 cm
thrombolysis catheter with 50 cm of sideholes was inserted from
the let popliteal vein to the IVC and secured to the sheath. A
continuous infusion of 1 mg/hour TPA is to be initiated in the
PICU.
Permanent ultrasound and fluoroscopic images were obtained and
stored in the PACS system.
IMPRESSION
Successful placement of left 5 French 90 cm (50cm
infusion) thrombolysis catheter spanning left lower extremity
venous thrombus.
Results
Exactly which codes would
you use for the venogram and catheter placement prior to 37212?
Preliminary lower IVC sonography finds no IVC clot. The patient
was placed prone on the x-ray table and an ultrasound of the left
popliteal vein was performed . A suitable skin site was marked.
The popliteal fossa was prepared and draped in the usual sterile
fashion. Using ultrasound guidance a 21 gauge needle puncture
needle was advanced into the left popliteal vein and a 0.018
Mandril wire was advanced under fluoroscopic guidance. A 5 French
micropuncture dilator was then inserted and 0.018 inch Mandril
was exchanged for a 0.035 inch Glidewire and a 7F vascular sheath
was placed. Using a JB-1 catheter and the glidewire the catheter
was manipulated into the distal IVC and contrast was injected
demonstrating a patent IVC. The JB-1 catheter was then withdrawn
to the level of the left common iliac vein and injected
demonstrating nonocclusive thrombus at this level. A 5F 90 cm
thrombolysis catheter with 50 cm of sideholes was inserted from
the let popliteal vein to the IVC and secured to the sheath. A
continuous infusion of 1 mg/hour TPA is to be initiated in the
PICU.
Permanent ultrasound and fluoroscopic images were obtained and
stored in the PACS system.
IMPRESSION
Successful placement of left 5 French 90 cm (50cm
infusion) thrombolysis catheter spanning left lower extremity
venous thrombus.
Results