Sclerotherapy of tongue/inferior labial venous malformation


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Hello All Coders:)
Our physician performed Percutaneous Sodium Morrhuate Sclerotherapy Tongue/Inferior Labial Venous Malformation, Direct Puncture Venography of Tongue/lower lip & Diagnostic Cervicocerebral angiogram.

Per report details:
The Anterior tongue (6 regions) & lower lip (3 regions) was injected with sodium morrhuate solution.
Direct puncture of the lower lip & tongue malformation was performed w/ a 22 gauge butterfly needle in 9 location with good venous return in locations. Multiple venograms were performed with 50% diluted contrast & filmed a 1frame/second. Percutaneous sclerotherapy was perfomed under fluoroscopic guidance with sodium morrhuate 50% with contrast( the following volumes were injected 0.5ml lower lip,lt lower lip, right inferior tongue, 2ml rt tongue, 3ml dorsal lt tongue, 4ml dorsal lt tongue, 3ml lt tip of tongue. 1.5ml dorsal lt tongue for a total of 16 ml. Following the completion of the embolization the butterfly needle was removed and manual compression was applied with adequate hemostasis.
Each injection has a separate S&I interpertation per injection by location.

We're reviewing CPT code 36469 (single/multi injection for sclerosing solutions spider veins: face) for the above service.
Also, CPT code indicate it use for spider veins, but this treatment was done for AVM disorder.
Can we code for the Venography in the same setting?
Is this consider an Embolization?

Thanks all in advance.


True Blue
Alexandria, LA
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You can't use 36469 since this isn't spider veins. None of the cath codes work, nor does it qualify for venography. It's not a transcatheter embolization, so 37204 is out. Code 37799 for the entire procedure.