margaret fahy
Guru
08/28/13
Hi, Guys,
For IR report below, I coded the Angiocath (36410-59), and Injection into Catheter (36598).
Dr. then documents three venograms but not injections for same. So, would I bill just 75820-rt/lt and a 75825?
Margie
CLINICAL HISTORY: End stage renal disease with failed right arm
fistula. Difficult aspiration from the red lumen.
PROCEDURE: Ultrasound evaluation of the right wrist was
performed to identify a suitable vein for peripheral intravenous
cannulation. The radial vein at the wrist was chosen. The
overlying skin was cleansed using chlorhexidine. Under sterile
ultrasound guidance a 22-gauge peripheral intravenous catheter
was inserted into the radial vein. This aspirated and flushed
without difficulty was secured.
Scout image of the chest demonstrated the tip of the dialysis
catheter to be in the mid right atrium. 2 areas of mild kinking
identified in the subcutaneous tract. Injection of the shorter
red lumen showed contrast tracking up the catheter into the SVC
and refluxing into the azygos vein. Injection of the blue longer
lumen showed normal flow of contrast away from the tip of the
catheter.
Right arm venography was performed with nonvisualization of the
cephalic and basilic veins in the forearm despite attempts at
occluding veins in the upper arm. The brachial and cephalic
veins are normal in the upper arm. The basilic vein is not
visualized in the right upper arm.
Left arm venography was performed demonstrating diminutive veins
throughout the forearm. In the upper arm the cephalic, basilic,
and brachial veins are diminutive.
Central venography showed normal appearance of the left
axillary, subclavian, and brachiocephalic veins. The right
axillary and brachiocephalic veins are widely patent without
evidence of stenosis. There is mild narrowing of the right
subclavian vein centrally with no surrounding collateral flow to
suggest hemodynamically significant stenosis. The SVC is patent.
Hi, Guys,
For IR report below, I coded the Angiocath (36410-59), and Injection into Catheter (36598).
Dr. then documents three venograms but not injections for same. So, would I bill just 75820-rt/lt and a 75825?
Margie
CLINICAL HISTORY: End stage renal disease with failed right arm
fistula. Difficult aspiration from the red lumen.
PROCEDURE: Ultrasound evaluation of the right wrist was
performed to identify a suitable vein for peripheral intravenous
cannulation. The radial vein at the wrist was chosen. The
overlying skin was cleansed using chlorhexidine. Under sterile
ultrasound guidance a 22-gauge peripheral intravenous catheter
was inserted into the radial vein. This aspirated and flushed
without difficulty was secured.
Scout image of the chest demonstrated the tip of the dialysis
catheter to be in the mid right atrium. 2 areas of mild kinking
identified in the subcutaneous tract. Injection of the shorter
red lumen showed contrast tracking up the catheter into the SVC
and refluxing into the azygos vein. Injection of the blue longer
lumen showed normal flow of contrast away from the tip of the
catheter.
Right arm venography was performed with nonvisualization of the
cephalic and basilic veins in the forearm despite attempts at
occluding veins in the upper arm. The brachial and cephalic
veins are normal in the upper arm. The basilic vein is not
visualized in the right upper arm.
Left arm venography was performed demonstrating diminutive veins
throughout the forearm. In the upper arm the cephalic, basilic,
and brachial veins are diminutive.
Central venography showed normal appearance of the left
axillary, subclavian, and brachiocephalic veins. The right
axillary and brachiocephalic veins are widely patent without
evidence of stenosis. There is mild narrowing of the right
subclavian vein centrally with no surrounding collateral flow to
suggest hemodynamically significant stenosis. The SVC is patent.
