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Thread: Gluing of abscess tract

  1. #1

    Default Gluing of abscess tract

    AAPC: Back to School
    My IR doc glued an abscess tract that continued to leak externally. He used a Tisseel agent. Not sure what code to use for the actual gluing of the tract.
    Need help please.
    Thank you,

  2. #2
    Join Date
    Apr 2007
    New Delhi, India


    Please provide OP report.
    Girish Dadhich, CPC

  3. #3


    Here is the OP report
    TECHNIQUE: Patient presents with previously documented small bowel fistula, previously resulting in an abscess, which was drained percutaneously. Despite prolonged catheter drainage fistula persists.

    Explained nature and purpose of proposed embolization procedure to patient and patient's wife, reviewing potential risks and complications, including recurrent abscess formation requiring repeat catheter insertion. Patient and wife understand and have agreed to proceed.

    Patient's indwelling percutaneous drainage catheter injected with contrast material, redemonstrating fistula into small bowel. Guidewire inserted through existing catheter, which was subsequently removed and replaced with a 5 French diagnostic catheter. Through this catheter Gelfoam slurry was injected, coupled with Tisseel fibrin sealant. Catheter placed as close as possible to small bowel defect.

    As a temporary precautionary measure a smaller 8 French percutaneous drainage catheter was left in place.

    Patient tolerated procedure without immediate difficulty. Approximately 9 minutes of intermittent fluoroscopy utilized.

  4. #4
    Join Date
    Apr 2007
    New Delhi, India


    I am leaning towards 37204, but I think we should add mod 52 (reduced services) since the guidewire is introduced through an already placed catheter, so that should be discounted. Any more thoughts???
    Girish Dadhich, CPC

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