Ask Dr. Z

Would you code the subclavian angiography, or is it considered inclusive to the temporary pacemaker insertion? "Indication: Complete heart block. The options of IJ and right subclavian access were examined, and decision was made to pursue with the placement of pacemaker through the right subclavian vein. Right subclavian vein angiography: Subclavian vein angiography was performed through the 6 French sheath placed in the right subclavian vein. Right subclavian access was obtained with the micropuncture system and sheath was placed, but the temporary pacemaker was not floating to the superior vena cava and instead was going to the left subclavian vein. At this time right subclavian vein angiography was done, which did show no obvious venous abnormality, and the sheath was pulled back slowly to get the wire across to the superior vena cava, but sheath came out and it required a additional access to the right subclavian vein followed by his successful placement of temporary pacemaker."