Ask Dr. Z

We have a patient who had a procedure done that I've never seen before. I'm getting the following codes: 36481 for the portal vein catheterization, 36000 for the femoral vein catheterization, and I am wondering if I can code 36430 as well? "The right upper quadrant and right groin were prepped and draped using sterile technique. Under ultrasound guidance, the right portal vein was accessed with AccuStick set, and microwire was advanced into the main portal vein. The inner stylet and microwire were removed with immediate return of pressurized venous blood. Portal venous catheterization was confirmed with injection of approximately 10 cc of contrast and portable spot radiography. A 035 guidewire was advanced into the portal vein, the percutaneous tract was serially dilated, and a 9 French sheath was placed into the main portal vein. Positioning was confirmed with portable spot radiography."