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Thread: aspiration of thrombus from the varicosities - 78 year old male with insufficiency

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    Default aspiration of thrombus from the varicosities - 78 year old male with insufficiency

    AAPC: Back to School
    How to code this report,My codes are
    93971 26
    Please confirm.

    78 year old male with insufficiency of the left short
    saphenous vein status post successful EVLT of this vein two months
    ago, status post sclerotherapy of residual varicosities within the
    posterior calf 3 weeks ago returns for follow up examination.

    Mr. XXX states that he feels well. He is notes some tenderness
    to palpation and a "hard feeling" at the sclerotherapy injection
    sites. Physical examination of the left leg and foot demonstrates
    several palpable
    cords posterior to the left knee. Minimal discoloration is noted
    posterior to the knee. Doppler ultrasound examination of the left
    lower extremity veins demonstrates continued occlusion of the
    short saphenous vein within the calf. Previously sclerosed
    varicosities within the calf are thrombosed.

    The posterior calf was then prepped with alcohol solution. Local
    anesthesia was administered to the tissue surrounding the
    thrombosed varicosities. Using 18 gauge needles, aspiration of
    thrombus from the varicosities was performed. A large amount of
    thrombus was aspirated from the varicosities with significant
    decompression of them.the catheter was wrapped with an Ace wrap.
    The patient is to return for follow-up examination in two months.
    Last edited by ank3t; 10-04-2016 at 05:55 AM.
    Shirley CPC,CPC-H

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