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Indirect Portal Venogram vs Direct Portal Venogram

Date: Sep 23, 2022

Question:

Is this indirect portal venogram billed with 36481 in addition to the hepatic veins selection?

"US-guided RIJ vein access, hepatic fourth order vein selection. Transcatheter venous pressure measurement, indirect portal venogram. RIJ vein was accessed under continued US guidance. A single US image of access was obtained for documentation. A wire was advanced into a fourth order branch of the right hepatic vein, and a 5 French catheter was passed. The wire was removed and pressure measurements taken, both wedge and free. Right atrial pressure was measured. The catheter was wedged, and multiple indirect portal venograms were performed. The catheter was repositioned into the left hepatic vein, and then the middle hepatic vein and fourth order branches were selected. Multiple indirect portal venograms were performed in both these branches."

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