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Inflation catheter

  1. Default Inflation catheter
    Exam Training Packages
    What should be the code for this inflation?????????

    Procedure and Findings:
    With the patient in the supine position the left upper abdomen was
    prepped and draped in the usual sterile fashion. The catheter was
    flushed with sterile saline solution.Approximately 50 cc of
    bilious fluid with clots was aspirated.Contrast examination
    through the catheter demonstrates a nondilated collecting system
    with small intralumenal filling defects consistent with clots.
    The catheter was cut and exchanged over an Amplatz stiff guidewire
    for a seven French sheath. The sheath was slowly withdrawn
    proximally. Contrast injection along the tract demonstrates
    opacification of left hepatic artery branches. In addition, a
    collateral branch from the right hepatic artery appears to
    reconstitute these vessels. A 5.5-French over-the-wire Fogarty
    balloon catheter was then inflated along the tract
    between the
    artery and the biliary system
    for approximately 15 minutes.
    Following deflation, no further communication with the vessels is
    noted. A 10 French VTCB biliary drainage catheter was then
    replaced across the left biliary system. Gentle contrast
    administration demonstrates proper catheter positioning.The
    catheter was flushed with saline and aspirated until clear.The
    catheter was sutured to the skin and connected to gravity
    drainage. The patient tolerated the procedure without incident.

    Impression: Catheter cholangiogram demonstrates persistent
    arterial biliary fistula as described above. Previously embolized
    vessels are apparently reconstituted via communication with right
    hepatic artery branches. However, arterial evaluation is limited
    on this examination.

    Successful temporary tamponade of arterial biliary fistula using a
    5.5-French over-the-wire Fogarty balloon as described above. New
    10 French VTCB biliary drainage catheter was replaced across the
    left biliary tree and the left to external drainage as described
    above.
    Prabha CPC

  2. #2
    Default
    Quote Originally Posted by prabha View Post
    What should be the code for this inflation?????????

    Procedure and Findings:
    With the patient in the supine position the left upper abdomen was
    prepped and draped in the usual sterile fashion. The catheter was
    flushed with sterile saline solution.Approximately 50 cc of
    bilious fluid with clots was aspirated.Contrast examination
    through the catheter demonstrates a nondilated collecting system
    with small intralumenal filling defects consistent with clots.
    The catheter was cut and exchanged over an Amplatz stiff guidewire
    for a seven French sheath. The sheath was slowly withdrawn
    proximally. Contrast injection along the tract demonstrates
    opacification of left hepatic artery branches. In addition, a
    collateral branch from the right hepatic artery appears to
    reconstitute these vessels. A 5.5-French over-the-wire Fogarty
    balloon catheter was then inflated along the tract
    between the
    artery and the biliary system
    for approximately 15 minutes.
    Following deflation, no further communication with the vessels is
    noted. A 10 French VTCB biliary drainage catheter was then
    replaced across the left biliary system. Gentle contrast
    administration demonstrates proper catheter positioning.The
    catheter was flushed with saline and aspirated until clear.The
    catheter was sutured to the skin and connected to gravity
    drainage. The patient tolerated the procedure without incident.

    Impression: Catheter cholangiogram demonstrates persistent
    arterial biliary fistula as described above. Previously embolized
    vessels are apparently reconstituted via communication with right
    hepatic artery branches. However, arterial evaluation is limited
    on this examination.

    Successful temporary tamponade of arterial biliary fistula using a
    5.5-French over-the-wire Fogarty balloon as described above. New
    10 French VTCB biliary drainage catheter was replaced across the
    left biliary tree and the left to external drainage as described
    above.
    I looked through the SIR coding manual, and I did not see anything for the fogarty balloon portion of the exam. I believe you can only code for the biliary choleangiogram and catheter exchange.

  3. #3
    Default
    Hi Prabha,


    You can code Unlisted procedure 47999 and fwd the same with description of the procedure to your client with other codes as suggested.


    Thanks
    Prabhavathi

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