Just wanted a few opinions on how other coders are billing this procedure. (36469, UPC, etc.) Report below-
ULTRASOUND-GUIDED SCLEROTHERAPY FOR LYMPHANGIOMA OF LEFT FACE:
INFORMATION:
14-year-old male patient presents with lymphangioma with venous
elements of the left temporal region. This was previously treated with
sclerosis therapy in April 2004. Patient returns with recurrent
symptoms, not as great as previously seen.
TECHNIQUE:
Preliminary ultrasound demonstrates a small residual fluid
collection. This slightly greater than seen on the recent appointment
of approximately two weeks ago.
With intravenous Versed and Fentanyl, with Lidocaine 2% local
anesthetic, and in aseptic fashion, a needle was advanced into the
suspected area of fluid accumulation. Initial contrast injection
demonstrates filling outside of the lymphatic channels. The needle was
repositioned twice, eventually filling into a lymphatic appearing
channel. There is no flow into the veins.
Four ml (200 mg.) of ethanolamine oleate were then injected under
slow fluoroscopic and ultrasound guidance. The needle was removed. The
patient was held for observation prior to discharge.
IMPRESSION:
ETHANOLAMINE OLEATE SCLEROSIS AND INJECTION OF LYMPHANGIOMA OF THE
LEFT FACE, AS DESCRIBED ABOVE.
ULTRASOUND-GUIDED SCLEROTHERAPY FOR LYMPHANGIOMA OF LEFT FACE:
INFORMATION:
14-year-old male patient presents with lymphangioma with venous
elements of the left temporal region. This was previously treated with
sclerosis therapy in April 2004. Patient returns with recurrent
symptoms, not as great as previously seen.
TECHNIQUE:
Preliminary ultrasound demonstrates a small residual fluid
collection. This slightly greater than seen on the recent appointment
of approximately two weeks ago.
With intravenous Versed and Fentanyl, with Lidocaine 2% local
anesthetic, and in aseptic fashion, a needle was advanced into the
suspected area of fluid accumulation. Initial contrast injection
demonstrates filling outside of the lymphatic channels. The needle was
repositioned twice, eventually filling into a lymphatic appearing
channel. There is no flow into the veins.
Four ml (200 mg.) of ethanolamine oleate were then injected under
slow fluoroscopic and ultrasound guidance. The needle was removed. The
patient was held for observation prior to discharge.
IMPRESSION:
ETHANOLAMINE OLEATE SCLEROSIS AND INJECTION OF LYMPHANGIOMA OF THE
LEFT FACE, AS DESCRIBED ABOVE.