Ask Dr. Z

Should I report 33017 or unlisted code 33999? 

"Due to the presence of a large anterior mediastinal lymphoma with pericardial invasion, simple pericardiocentesis was not recommended. Insertion of a tunneled drain catheter was recommended by the Thoracic Surgery team. The patient was sedated with IV midazolam, fentanyl, ketamine, and propofol. The anterior chest and abdomen were prepped and draped. Local anesthesia was obtained with 1% lidocaine. The pericardium was punctured under ultrasound guidance. The Pleurex drain catheter was inserted and tunneled to an exit site on the abdominal wall. The incisions were closed with subdermal, absorbable suture and Dermabond. Turbid, blood-tinged fluid was removed. The gross appearance was consistent with a malignant effusion. Fluid samples were sent to the laboratory for culture and cytology. The catheter was capped and dressed. Sedation was discontinued, and the patient was observed until awake."