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? Re venogram/cath placement prior to procedure

  1. Default ? Re venogram/cath placement prior to procedure
    Medical Coding Books
    Hey Folks,
    Exactly which codes would
    you use for the venogram and catheter placement prior to 37212?

    Preliminary lower IVC sonography finds no IVC clot. The patient
    was placed prone on the x-ray table and an ultrasound of the left
    popliteal vein was performed . A suitable skin site was marked.
    The popliteal fossa was prepared and draped in the usual sterile
    fashion. Using ultrasound guidance a 21 gauge needle puncture
    needle was advanced into the left popliteal vein and a 0.018
    Mandril wire was advanced under fluoroscopic guidance. A 5 French
    micropuncture dilator was then inserted and 0.018 inch Mandril
    was exchanged for a 0.035 inch Glidewire and a 7F vascular sheath
    was placed. Using a JB-1 catheter and the glidewire the catheter
    was manipulated into the distal IVC and contrast was injected
    demonstrating a patent IVC. The JB-1 catheter was then withdrawn
    to the level of the left common iliac vein and injected
    demonstrating nonocclusive thrombus at this level. A 5F 90 cm
    thrombolysis catheter with 50 cm of sideholes was inserted from
    the let popliteal vein to the IVC and secured to the sheath. A
    continuous infusion of 1 mg/hour TPA is to be initiated in the
    PICU.

    Permanent ultrasound and fluoroscopic images were obtained and
    stored in the PACS system.

    IMPRESSION
    Successful placement of left 5 French 90 cm (50cm
    infusion) thrombolysis catheter spanning left lower extremity
    venous thrombus.

    Results

  2. #2
    Default
    Quote Originally Posted by margaret fahy View Post
    Hey Folks,
    Exactly which codes would
    you use for the venogram and catheter placement prior to 37212?

    Preliminary lower IVC sonography finds no IVC clot. The patient
    was placed prone on the x-ray table and an ultrasound of the left
    popliteal vein was performed . A suitable skin site was marked.
    The popliteal fossa was prepared and draped in the usual sterile
    fashion. Using ultrasound guidance a 21 gauge needle puncture
    needle was advanced into the left popliteal vein and a 0.018
    Mandril wire was advanced under fluoroscopic guidance. A 5 French
    micropuncture dilator was then inserted and 0.018 inch Mandril
    was exchanged for a 0.035 inch Glidewire and a 7F vascular sheath
    was placed. Using a JB-1 catheter and the glidewire the catheter
    was manipulated into the distal IVC and contrast was injected
    demonstrating a patent IVC. The JB-1 catheter was then withdrawn
    to the level of the left common iliac vein and injected
    demonstrating nonocclusive thrombus at this level. A 5F 90 cm
    thrombolysis catheter with 50 cm of sideholes was inserted from
    the let popliteal vein to the IVC and secured to the sheath. A
    continuous infusion of 1 mg/hour TPA is to be initiated in the
    PICU.

    Permanent ultrasound and fluoroscopic images were obtained and
    stored in the PACS system.

    IMPRESSION
    Successful placement of left 5 French 90 cm (50cm
    infusion) thrombolysis catheter spanning left lower extremity
    venous thrombus.

    Results
    I would code 36010, 75820, 75825, 37212. Diagnostic venogram is billable before thrombolysis.
    HTH,
    Jim Pawloski, CIRCC

  3. Default
    Jim,
    Thanks so much....I had the IVC piece, but I get confused....venogram and catheter placement for procedure..
    Have a great day.
    Margie

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