Patient placed on the table and under fluoro, made sure the balloon inflation device was deflated, it was. Then attemped to gently put tension on the Swan-ganz cathether, but would not pullback. Magnified imaging of the Swan-ganz catheter demonstrated a high grade kink and crimping of the cath at the area of the tricuspid valve annulus, very close area where sutures were placed at the annuloplasty ring. With gentle tugging, this did not give at all and for fear of damaging the heart or causing tamponade further attempts at manually removing the cath were aborted.

I can't find a code that captures his work. Any thoughts? Is it billable? Pt had undergone a Mitral valve replacement and Tricupid valve repair with the indwelling Swan-Ganz catheter following the procedure. Any suggestions are greatly appreciated.