Ask Dr. Z

"While attempting a PVI the physician encountered tortuous femoral veins requiring venography. An attempt was made to place a duodecapolar catheter via the left femoral vein. Catheter could not navigate through the tortuosity. A venogram of the left femoral vein was obtained, demonstrating significant tortuosity of left femoral vein. An angled guidewire navigated the tortuosity, and sheath was placed into the inferior vena cava and allowed placement of duodecapolar catheter into position in right atrium and coronary sinus. Through the right femoral vein a catheter was advanced to superior vena cava. Attempted to advance guidewire from right femoral vein to superior vena cava. Encountered great resistance at junction of right femoral vein and inferior vena cava. Guidewire advanced into superior vena cava. Dilator placed prior, also could not navigate this point. Venography demonstrated an apparent stenosis of the vein with significant collateralization. Cavotricuspid isthmus was eventually ablated." Is the venography billable? If so, what are the appropriate codes?