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36005 different access site with 33249

Date: Apr 3, 2018

Question:

"A venogram of the left subclavian and axillary vein was performed, which demonstrated a small vessel with the question of possible downstream collateralization. Using sharp and blunt dissection, a pocket was created on top of the pectoralis muscle. Access was obtained in the left axillary vein using the modified Seldinger technique under fluoroscopy and ultrasound guidance. A 5 sheath was placed over a Glide wire, and then a selective venogram was performed in the subclavian vein. This demostrated a complete occlusion and thrombosis of the mid subclavian vein with significant collaterals. The wire could not be passed through this obstruction. At this point, the wound was closed in a 3-layer fashion with absorbable suture. A venogram of the right axillary and subclavian vein was done. Found to be patent. A pocket was fashioned and continued with the placement the dual chamber ICD." Can we report the attempted left axillary access selective venogram of subclavian vein with code 36005-XS?

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