Ask Dr. Z

Coding unsuccessful procedures is sometimes confusing to me. Would I code this attempted tunneled cath placement as 36558-53, 77001, and 76937? The doc wants to add 36010. "The right internal jugular vein was punctured under direct ultrasound guidance. A 0.018 inch guidewire was advanced through the needle and was unable to be advanced into the SVC. A small amount of contrast was injected through the micropuncture needle, showing collateral flow without filling of SVC. The procedure was halted, and the right side was further interrogated in the angiography suite later on the same day. IMPRESSION: 1) Technically unsuccessful ultrasound and fluoroscopically-guided placement of Perm-cath via the right internal jugular vein. 2) Patient went on to have tunneled hemodialysis catheter placed in the angiography suite later on the same day."