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Direct Puncture Sclerotherapy

  1. #1
    Default Direct Puncture Sclerotherapy
    Medical Coding Books
    Good Morning Coders
    I have a procedure I have not coded before and need help. The patient had Direct Puncture Sclerotherapy (3 injections) of the nasal/pharyngeal area for venous malformation, see partial report:

    An ENT retractor was placed for the procedure. Endoscopes
    were used to visualize the extent of the vascular lesion
    involving the nasal/oropharynx. Once this was done, a
    total of 3 micropuncture needles were placed into the
    vascular malformation at various locations. There was no
    significant bleeding. Subsequently, each needle was
    injected with contrast dye to insure proper position within
    the vascular malformation. Direct-puncture sclerotherapy
    was then performed using 2% Ethamolin. The sclerosing
    agent was mixed in a 50:50 solution with contrast dye for
    visualization. Approximately 4 ml of Ethamolin was
    injected under fluoroscopic guidance.

    I am leaning towards 36470 (per SIR, AMA not just for leg). Would that be billed x3? Or an unlisted coded? Any other codes?

    Thank you for your input!


  2. #2
    Alexandria, LA
    Yes 36470 can be used for a site other than leg, but it also says "single vein". That's not what you did.
    I would code 37799.

  3. #3
    thanks Donna. I think I will value it close to 36470 x3? Does that sound right?

  4. #4
    Fayetteville, NC
    What about 36469? Single or multiple injections of sclerosing solutions, spider veins face
    A. McCormick, CPC, CGSC
    Walters Surgical Associates

  5. #5
    I saw that, but this was sclerotheray for a venous hemangioma/malformation...I didn't see any RVU's attached to that, but it seemed like a lesser procdure than he did. Thanks for the suggestion unlisted are my fav! not!

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