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Lymphangiogram with embolization, drain exchange, and sclerosing
Question:
FINDINGS:
1. Injection of the right inguinal lymph node demonstrates connection and leakage into the space surrounding the JP drain in the right lower quadrant. Glue/lipiodol was injected, which filled up two of the afferent channels from the accessed lymph node.
2. Images from the catheter injection demonstrate no significant cavity.
3. The catheter was draining clear straw-colored fluid.
Impression: Lymphatic leak into the space surrounding the the right lower quadrant drain status post successful lymphangiogram with glue embolization, drain exchange, and alcohol sclerosis of the space surrounding the drain.
I have coded 37244, 38790, and 49423. I am hesitant to report code 49185 because it sounds like one site that is communicating, and there is an edit between codes 37244 and 49185. Would it be appropriate to report code 49185 with a modifier here?
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