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Items Tagged: placement
Jul 14, 2020
Q & A July 2020
Question: Embolization Dialysis Collateral Vein
Can you please let me know if I coded this correctly? The doctor says I should be able to code the cath placement into the collateral vein and the venogram. I thought it was included in the fistulogram and embolization.
US guided access into left forearm AV fistula (all documentation is there) 76937-26 fistulogram of left radiocephalic AV fistula and Central Venogram - PTA peripheral dialysis circuit in the outflow vein. 36902 Selective catheterization of lateral collateral vein arising from the peripheral juxta anastomotic outflow vein (included in embolization ?) Venogram of selected collateral forearm vein ( billable?) Embolization of selected collateral forearm vein 36909. My doctor asked me to verify with you.
Jan 30, 2017
January 2017 Q & A
Question: 32551 vs 32557
IR chest tube placement.
Indication: Large symptomatic right pneumothorax status post CT-guided lung biopsy.
Technique: The patient was placed supine on the fluoroscopy table. The right hemithorax was prepped and draped in a sterile fashion. The fifth and sixth rib interspace was localized with fluoroscopy, and 1% lidocaine was utilized for local anesthesia. A Cook pneumothorax 9 French drainage catheter was placed into the right pleural space using a trocar under direct fluoroscopic surveillance. The drain was then connected to a Heimlich valve, and good reexpansion of the right lung was achieved after the patient coughed. Postprocedural images demonstrate a small residual right apical pneumothorax with the drainage catheter overlying the anterior midlung zone.
Impression: Successful placement of 9 French chest tube with satisfactory re-expansion of the right lung.
Apr 25, 2016
April 2016 Q & A
Question: Popliteal Aneurysm
We are looking for a code for popliteal aneurysm (37236?). This is what one of our physicians said: "34900 code is an aneurysm procedure code, and although specifies iliac it is far more reflective of the procedure type and work, including large sheath placement that is involved with popliteal aneurysm repair. In fact the 2 procedures are almost identical except one is done at a more distal location." What code do you suggest we use for popliteal aneurysm and why?
Jul 28, 2015
July 2015 Q & A
Question: 2 Infusion Catheters, 2 Graft Punctures for Access of the Same Leg
The patient has a left femoral to below-knee popliteal artery bypass graft and a left abandoned bypass graft. A micropuncture needle was advanced in a midline retrograde fashion and a sheath placed. A pelvic angiogram shows occlusion of the bypass graft and a 10 cm infusion Cragg-McNamara infusion catheter is placed and positioned across the proximal arterial anastomosis. Then under direct ultrasound guidance, a micropuncture needle was advanced into the proximal graft in an antegrade fashion, then a sheath was placed, followed by lower extremity angiography.
Jun 13, 2015
June 2015 Q & A
Question: Balloon Dilatation and Stenting of Intrathoracic Innominate Artery
The doctor would like to charge 36217, 37218, 75710-26 for this procedure: 1. Right femoral artery cannulated in retrograde fashion. 2. Catheter into orgin of the innominate. 3. Then catheter passed selectively into the origin of the common carotid artery. 4. Then catheter selective out into the subclavian and selctive angiography was performed and confirmed subclavian widely patent. 5. Balloon dilatation performed and did not get good result. 6. Stent placed over ostial and proximal portion of innominate artery.