Ask Dr. Z

Can we bill for catheter placement and if so, would you code 36010 (svc to get to RA) and 36200 (aorta) to access LV?

"Access was obtained in the left femoral vein, and right femoral artery where 10F and 7F sheaths were placed using a modified Seldinger technique. Through the venous sheath, an ICE catheter was advanced into the RA. Initial images were obtained showing device in the LVOT. Prior to upsizing the arterial sheath, two Perclose sutures were prepared and delivered in the artery. The right femoral artery sheath was removed, and the vessel was dilated using a 14F dilator. We then upsized to a 14F D'Vill sheath in the right femoral artery. Using a 6F JR 3.5, and a 6F 6-10mm Ensnare, the device was captured in the LV. The sheath was advanced into the LV, and the Amplatzer device was pulled within the long sheath and removed. We performed final ICE which demonstrated mild AI, and mild MR. We decided not to replace the ASD device."