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Port-A-Cath injection under fluoroscopy

  1. #1
    Location
    Dallas Ga
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    Default Port-A-Cath injection under fluoroscopy
    Medical Coding Books
    OK, so I am just being a problem child tonight....or else I am just loosing it, LOL

    But can anyone clarify for me what code or codes I should be using for this?

    Thanks in advance!

    Port-A-Cath injection under fluoroscopy

    Intravenous contrast injection through an indwelling subcutaneous port through a Huber needle access by floor nurse demonstrates the extravasation of contrast material around the port tubing.
    The exact lead and origin of the extravasation is difficult to determine. The epicenter appears to be at the junction of the port to the catheter and then the contrast tracks along the catheter to about the
    head of the clavicle. The catheter is confirmed patent and it appears continuous. Some of the contrast media particularly along the mid catheter flushes with saline flush but there is still a pooling of extravasated contrast around the proximal portion of the tubing and catheter port junction.

    Impression: The left subclavian Port-A-Cath is confirmed patent but there is extravasation of contrast around the proximal portion of the tubing and subcutaneous port during injection. The path of the extravasated material favors a leak of the tubing or connection to the port although leakage around the needle tracks into the port is also considered. The extravasated contrast,
    however, does not fully surround the port but tracks along the proximal portion of the catheter and partially flushes with saline flush through the catheter.

  2. #2
    Location
    Birmingham, Alabama
    Posts
    889
    Default
    Quote Originally Posted by baash1124 View Post
    OK, so I am just being a problem child tonight....or else I am just loosing it, LOL

    But can anyone clarify for me what code or codes I should be using for this?

    Thanks in advance!

    Port-A-Cath injection under fluoroscopy

    Intravenous contrast injection through an indwelling subcutaneous port through a Huber needle access by floor nurse demonstrates the extravasation of contrast material around the port tubing.
    The exact lead and origin of the extravasation is difficult to determine. The epicenter appears to be at the junction of the port to the catheter and then the contrast tracks along the catheter to about the
    head of the clavicle. The catheter is confirmed patent and it appears continuous. Some of the contrast media particularly along the mid catheter flushes with saline flush but there is still a pooling of extravasated contrast around the proximal portion of the tubing and catheter port junction.

    Impression: The left subclavian Port-A-Cath is confirmed patent but there is extravasation of contrast around the proximal portion of the tubing and subcutaneous port during injection. The path of the extravasated material favors a leak of the tubing or connection to the port although leakage around the needle tracks into the port is also considered. The extravasated contrast,
    however, does not fully surround the port but tracks along the proximal portion of the catheter and partially flushes with saline flush through the catheter.
    I think 36598 fits this scenario.
    Danny L. Peoples
    CIRCC,CPC

  3. #3
    Default
    I was thinking 36598, but the first part about the floor nurse threw me off...did the nurse just access the port and the phys inject?

  4. #4
    Location
    Dallas Ga
    Posts
    16
    Default
    Thanks Danny, I thought this code would work, but the way it was worded and the late hour last night just threw me off.

    Your input is GREATLY appreciated!!!

    Bridget

  5. #5
    Location
    Dallas Ga
    Posts
    16
    Default
    it is my understanding that access was provided by the floor nurse, but inj by phys. worded very strangely I will say...

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