Wiki Vein ablation procedure note_need CPT code??

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Ahmadabad, GJ
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Please help me with the CPT code...


Indications for Procedure:
Please refer to clinical notes. Patient has had continuation of symptoms despite 3 months of conservative medical therapy. The patient underwent informed consent including management options where the complications of infection, bleeding, pain, and skin injury were discussed. Particular attention was spent discussing thrombus extension and deep vein thrombosis.

Anesthesia: Local infiltration 5 cc. Tumescent 4 cc.

Procedure: Endovenous laser ablation of the Great Saphenous

The left lower extremity was prepared and draped to allow knee flexion in the sterile field. A 7.5 mhz duplex ultrasound probe draped in a sterile sleeve and covered with ultrasound transmission gel was introduced. Venous mapping was performed prior to the procedure. The total length was 25 cm from the entry below the knee to 2 cm below the Saphenofemoral Junction (SFJ). The diameter of the vein ranged from 13 mm near the SFJ to 6.4 mm at the entry point.
Using a 21 gauge needle the entry site was anesthetized with 1% lidocaine.
A small skin incision was made with a 11 inch knife and the Saphenous vein was entered percutaneously under ultrasound guidance with a micropuncture set (21 gauge needle). A microwire was inserted and the 21 gauge needle was removed. A microset, including a dilator, was inserted over the microwire and the needle and dilator was removed. A J type guidewire was inserted through the microset and threaded through the saphenous vein to the SFJ. The dilator was removed and a 64 cm introducer sheath was inserted over the J wire until the end of the sheath entered the SFJ. The dilator and wire were removed and a 600 micron fiber was introduced and placed into position so that it extended beyond the sheath and 2 cm peripheral to the SFJ. The final position of the fiber was determined by ultrasound guidance and duplex imaging. Tumescent anesthetic was delivered by ultrasound guidance. A solution consisting of 50 cc’s of 1 % lidocaine in 500 cc’s of saline was delivered along the course of the Saphenous vein. A final positioning check was made. The energy source was turned on by means of a foot- pedal and the fiber and sheath were withdrawn. The total number of joules delivered was 68 joules. The total time of energy delivery was 19 seconds. A duplex ultrasound revealed compressibility and flow at the SFJ immediately after the procedure.

Hemostasis of access site was achieved post-op. The skin incision over the saphenous vein​

was closed with aceband . A compression stocking was placed on the treated vein.
 
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