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Follow up infusion therapy

  1. Default Follow up infusion therapy
    Medical Coding Books
    Can anyone confirm me the codes for the below procedure.......

    37201
    75896-26
    75898-26

    The patient's right groin, existing sheath and catheter were
    double prepped and draped in the usual sterile manner and locally
    anesthetized with 1% lidocaine. The existing multi-sidehole
    infusion catheter(placed overnight) was exchanged out over an exchange length wire.
    Contrast was injected over the up and over vascular sheath and
    digital subtraction angiography was performed of the left lower
    extremity in multiple stations. A total of 35 cc of Visipaque 270
    used as intravascular contrast. 3.3 minutes fluoroscopy time.

    Findings:
    The distal superficial femoral artery is now patent, status post
    overnight thrombolytic infusion. The popliteal artery, however is
    occluded. There is reconstitution of all 3 tibial arteries at
    their origin, with visualization of the anterior tibial,
    tibioperoneal trunk, peroneal and posterior tibial arteries.

    After restoration of patency to the SFA, now the proximal hood of
    the bypass graft is identifiable.

    Intervention:

    A decision was made to catheterize the bypass graft now that its
    location is identifiable, and position a multi-sidehole infusion
    catheter in the bypass graft to allow for infusion directly into
    the bypass graft throughout the day. Later in the afternoon the
    patient will be brought brought back down for followup imaging.

    A Berenstein catheter and Bentson wire were used to easily
    selectively catheterize the bypass graft. The Bentson wire did
    advance into the bypass graft. The distal anastomosis, however
    could not be negotiated and the catheter kept entering what
    appeared to be a collateral vessel.

    A 10 cm multi-sidehole infusion infusion catheter was then placed
    with the sideholes across the occluded bypass graft. Plan to
    infuse 0.75 mg TPA per hour for the next 5 hours or so, at which
    time he will come back for followup imaging. Also plan to continue
    low dose heparin infusion via the up and over vascular sheath to
    prevent pericatheter thrombosis.

    Impression:
    The distal SFA is now patent status post overnight thrombolytic
    infusion. Also, the hood of the distal bypass graft which arises
    from the distal SFA is now identifiable. There is reconstitution
    at the tibial trifurcation, with runoff via all 3 tibial vessels.

    Now that the bypass graft is identifiable, it was easily
    selectively catheterized and a 10 cm multi-sidehole infusion
    catheter placed across the occluded bypass graft.
    Prabha CPC

  2. #2
    Location
    Birmingham, Alabama
    Posts
    889
    Default
    Quote Originally Posted by prabha View Post
    Can anyone confirm me the codes for the below procedure.......

    37201
    75896-26
    75898-26

    The patient's right groin, existing sheath and catheter were
    double prepped and draped in the usual sterile manner and locally
    anesthetized with 1% lidocaine. The existing multi-sidehole
    infusion catheter(placed overnight) was exchanged out over an exchange length wire.


    Contrast was injected over the up and over vascular sheath and digital
    subtraction angiography was performed of the left lower
    extremity in multiple stations. A total of 35 cc of Visipaque 270
    used as intravascular contrast. 3.3 minutes fluoroscopy time.

    Findings:
    The distal superficial femoral artery is now patent, status post
    overnight thrombolytic infusion. The popliteal artery, however is
    occluded. There is reconstitution of all 3 tibial arteries at
    their origin, with visualization of the anterior tibial,
    tibioperoneal trunk, peroneal and posterior tibial arteries.

    After restoration of patency to the SFA, now the proximal hood of
    the bypass graft is identifiable.

    Intervention:

    A decision was made to catheterize the bypass graft now that its
    location is identifiable, and position a multi-sidehole infusion
    catheter in the bypass graft to allow for infusion directly into
    the bypass graft throughout the day. Later in the afternoon the
    patient will be brought brought back down for followup imaging.

    A Berenstein catheter and Bentson wire were used to easily
    selectively catheterize the bypass graft. The Bentson wire did
    advance into the bypass graft. The distal anastomosis, however
    could not be negotiated and the catheter kept entering what
    appeared to be a collateral vessel.

    A 10 cm multi-sidehole infusion infusion catheter was then placed
    with the sideholes across the occluded bypass graft. Plan to
    infuse 0.75 mg TPA per hour for the next 5 hours or so, at which
    time he will come back for followup imaging. Also plan to continue
    low dose heparin infusion via the up and over vascular sheath to
    prevent pericatheter thrombosis.

    Impression:
    The distal SFA is now patent status post overnight thrombolytic
    infusion. Also, the hood of the distal bypass graft which arises
    from the distal SFA is now identifiable. There is reconstitution
    at the tibial trifurcation, with runoff via all 3 tibial vessels.

    Now that the bypass graft is identifiable, it was easily
    selectively catheterized and a 10 cm multi-sidehole infusion
    catheter placed across the occluded bypass graft.

    If the Infusion catheter was placed the night before then it was probably prevsiouly coded (37201/75896) and should not be re-coded. The catheter selection codes (36245-36247) should not be re-coded either, nor basic exams (75710/75716). If arteries (bypass grafts) were not previously catheterized, you may code for selection and any new images taken.

    The most common scenario for follow up exams to infusion and contuing infusion is:
    37209 Exchange of previously placed intravascular catheter during thrombolyctic therapy.
    75900 is the companion Radiology S & I code .
    75898 is the follow up exam code.

    HTH
    Danny L. Peoples
    CIRCC,CPC

  3. Default
    Thanks Danny..
    Prabha CPC

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