Items Tagged: lymphatic

ZHealth Coding Newsletter - August 2016

August 2016 Q & A

Question: Embolization - 37241 for lymphatic malformation treatment

How do I code the following?
PROCEDURE: The left axillary lymphatic malformation was examined with ultrasound and a suitable access site for needle placement was identified and the skin marked. The left axilla was prepared and draped in the usual sterile fashion. Using ultrasound guidance the first site (site #1) in the deep aspect of the axillary region was accessed with a trocar 6.3 French Dawson-Mueller pigtail drain. Next, using ultrasound guidance, the second, more superficial site (segment #2) was accessed with a trocar 6.3 French Dawson-Mueller pigtail drain. Finally, a superficial collection (site #3) was accessed with a 21-gauge micropuncture needle through which direct injection of 2 mL of doxycycline was performed. The predominant injection solution composed of a 4:1 dilution of doxycycline (10 mg/mL): Omnipaque 300 was injected under ultrasound and fluoroscopic guidance, according to the following outline: A total of 160 mg doxycycline in 16 mL saline was injected.

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ZHealth Coding Newsletter - February 2014

Q & A with Dr. David Zielske

Question: Sclerotherapy for Lymphatic Malformations

In the past, the coding recommendation for direct sclerotherapy/embolization of lymphatic malformations was to use unlisted codes. With the new embolization codes for 2014, would 37241 be a possibility for these procedures? I looked at 37244 but since that is referring to extravasation, it doesn't appear to match the intent of the sclerotherapy/embolization. Although 37241 doesn't use the term lymphatics, both the CPT book and CPT Insiders refer to these embolization codes to be used when "arteries, veins, and lymphatics may all be the target of embolization". Would you recommend continuing to use the unlisted codes or using one of the 2014 codes?

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