Ask Dr. Z

"The MitraClip device was at this point positioned into a 2P2 configuration and deployed under TEE guidance. There was significant reduction of the LA pressure as well as significant reduction of the mitral valve regurgitation. After confirming the position, the clip was completely deployed. The delivery system was removed. A mobile thrombus was present in the right ventricle prior to the MitraClip deployment and went into the inferior vena cava, and in view of the presence now of the iatrogenic atrial septal defect, it was decided to implant an inferior vena cava filter prior to removing the wires from the right femoral vein, and a Bard IVC filter under fluoroscopic guidance was indeed deployed successfully and position verified by inferior vena cava angiogram." We are having a debate about the IVC filter placement. 33418 for Mitraclip, 36010, 37191. I don't feel 36010 is appropriate, as same access site was used.