margaret fahy
Guru
Guys,
Dr. placed a Femoral line. Usually we would bill 36555/36556. There was some confusion in the past as to whether these lines (femoral/jugular) were tunneled. I bill them as centrally inserted with 36555/36556.
In report below, dr. documents tunneling to the femoral vein from the thigh. I thought that for a tunneled line, there would be two sites, and a cuff.
Does this also qualify for a tunneled line?
: TUNNELED CENTRAL LINE INSERTION
PROCEDURE:
Limited ultrasound of the right leg was performed to identify
the common femoral vein and choose a site for insertion of the
central line. The skin of the right thigh was prepped and draped
in sterile fashion and local anesthesia using 6 mL 0.2%
ropivacaine was infused at the venous insertion site. Using
real- time ultrasound guidance a 21 gauge needle was inserted
into the right common femoral vein tunneled from the
anterolateral aspect of the mid thigh. Once venous blood return
was obtained a 0.018" Nitrexwire was inserted into the vein and
advanced to the right atrium. A small dermatotomy was made, the
tract was dilated, and a 5.5 F peel-away sheath was inserted
into the vein.
Via the peel-away sheath 5 French single lumen 45 cm total
length silicone catheter was inserted in the common femoral
vein. The catheter was advanced with fluoroscopic guidance until
the tip was at the RA/IVC junction. The peel-away sheath was
then removed. The catheter was fixed to the skin with a 3-0
Prolene suture. A sterile occlusive dressing was applied. The
Both ports of the catheter aspirated and flushed easily and were
heparinizeD.
Dr. placed a Femoral line. Usually we would bill 36555/36556. There was some confusion in the past as to whether these lines (femoral/jugular) were tunneled. I bill them as centrally inserted with 36555/36556.
In report below, dr. documents tunneling to the femoral vein from the thigh. I thought that for a tunneled line, there would be two sites, and a cuff.
Does this also qualify for a tunneled line?
: TUNNELED CENTRAL LINE INSERTION
PROCEDURE:
Limited ultrasound of the right leg was performed to identify
the common femoral vein and choose a site for insertion of the
central line. The skin of the right thigh was prepped and draped
in sterile fashion and local anesthesia using 6 mL 0.2%
ropivacaine was infused at the venous insertion site. Using
real- time ultrasound guidance a 21 gauge needle was inserted
into the right common femoral vein tunneled from the
anterolateral aspect of the mid thigh. Once venous blood return
was obtained a 0.018" Nitrexwire was inserted into the vein and
advanced to the right atrium. A small dermatotomy was made, the
tract was dilated, and a 5.5 F peel-away sheath was inserted
into the vein.
Via the peel-away sheath 5 French single lumen 45 cm total
length silicone catheter was inserted in the common femoral
vein. The catheter was advanced with fluoroscopic guidance until
the tip was at the RA/IVC junction. The peel-away sheath was
then removed. The catheter was fixed to the skin with a 3-0
Prolene suture. A sterile occlusive dressing was applied. The
Both ports of the catheter aspirated and flushed easily and were
heparinizeD.
