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Central Venous Line Placement

  1. Default Central Venous Line Placement
    Medical Coding Books
    I need help coding this. I beleive it is 36556. Should I code the ultrasound as well? How do you determine if it is tunneled or non-tunneled?

    Indication: Hypotensive. Venous access needed for vasopressor infusion
    ( what dx would I use for that?)

    There was exaggerated distention of the external juglar and veins of the head and neck. Using the sonosite ultrasound, the right IJ was easily identified and the carotid artery was easily identified. The patient was then prepped and draped in the usual sterile fashion. Using appropriate sterile technique, gowns, gloves, mask and cap, the patient was positioned properly. The right internal juglar vein was easily entered using the sonosite ultrasound. A wire was passed through the needle and into position. The needle was removed. The wire could not be advanced all the way through the SVC and met persistent obstruction at approximately 9 cm from the skin. A small incision was made and a dilator passed over the wire. A triple lumen central venous line was then passed over the wire through the IJ. It was advanced to 9cm and, at that point, could not be adbvanced further. The wire was then removed.Again, attempts were made without success in advancing the triple lumen cath any further than 9cm at the skin.There was good blood return from all ports. The cath was easily flushed with saline. The cath was then secured in place at several sites. The vasopressors were instilled through the distal port and instructions given to maintain vasopressors visa distal pot only.


  2. #2
    Springfield Mo AAPC
    36556 with 77001-26 sounds like the codes you need, send me your fax # I will send you a Tool for catheters it has made my life so much easier.

    Denise Sullivan,CPC
    General & Specialty Surgery

  3. Default reply
    Hi thanks for the info!
    My fax number is 407-834-5011
    Also waht Dx should I use?

  4. #4
    Would you fax me a copy too? My fax is 432-335-2486. Anything to make those easier would be nice. Thanks

    Donna Gomez, CPC
    Texas Tech University Health Science Center

  5. #5
    St. Louis, Missouri
    Would you mind faxing me a copy of that too? Fax# 314-842-6184. Thanks.

    Melissa Blow, CPC

  6. Default Reply
    Thanks for the fax!

  7. Default
    Hi Denise,
    Would you mind if you fax me that tool also. My fax # 920-746-1072. Thank you so much

    Also, may I ask you a separate question
    When your physicians remove a perforated appendix and have to remove some of the cecum as well, do you code both 44960 & 44160? They do not bump up against each other in CCI edits.
    Thank you again,
    Marci Klaubauf, CPC

  8. #8
    Seacoast- Dover New Hampshire
    I would like one too...Karen Barron 6035697579...I love this forum!
    Karen Barron, CPC
    Hampton New Hampshire Chapter

  9. #9
    Default Me too please.
    Ok, I would also like to request a copy please.
    727 712-1853
    Thank you ,

  10. Default
    I would love a copy of that, too! LOL
    Fax: (386) 738-9537

    I do have a question, though. Why would we use 77001-26 and not 76937-26 if it was ultrasound guidance?

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