Ask Dr. Z

Is this reported with 33017 if the physician instilled fluid in the pericardial space during VT ablation? "40 mL of fluid was instilled within the pericardial space, then 3D mapping of the pericardial space was performed and the earliest breakout on the endocardial surface was identified. It was decided to do more extensive endocardial mapping with both the aortic approach, as well as the mitral approach with the HD grid was performed. The endocardial spot was much earlier than any of the epicarial spots. It was decided to give a single burn at this location, and following the burn, the patient still had inducible VT. It was clear that the VT focus was mid myocardium and was not accessible via the pericardial space or the endocardial space. A long guidewire was placed, and a standard pericardial drain was placed and the Agilis sheath removed. Then, 40 mL of blood-tinged fluid was removed and then 10 mL were injected back with 150 of Solu-Cortef. The pericardial drain was left to gravity drainage. It was sutured in place. The patient was then taken to the ICU in good condition."