Ask Dr. Z

I'm unsure how to code the following scenario: "Rate of pericardial drainage noted to be minimal over last 48+ hours. Drain clamped for nearly 24 hours, and opened this morning with no significant output. Echocardiogram with small global pericardial effusion, with inability to express fluid via drain. Drain disconnected from pigtail catheter. Attempts made to unclog by flushing saline, which flushed easily, with inability to briskly garner return from pigtail catheter. On three occasions, attempts made to unclog catheter tip with 0.035" j-tip and then 0.035" striaght wire under sterile conditions, with no change in drainage. Total of approximately 10-12cc saline flushed in and not returned. Trace amount pink-tinged serous fluid returned with aspiration. New drainage bag hooked up and left to gravity. Patient tolerated exchange and attempts to unclog wire well."