Ask Dr. Z

Would you suggest unlisted code 93799 or 33225-74? 

"The coronary sinus was cannulated with an EP catheter and a contrast injection through the sheath showed that the vessels were very tiny there was a lateral vessel and there was a middle cardiac vein however both were really timely. We were able to get out into the lateral vein with a whisper wire however the lead would not advance. Using a subselection tool we were unable to get the Glidewire very far past the mouth of the main body of the coronary sinus. Same thing happened with the middle cardiac vein. We can get to the septal portion of the middle cardiac vein however despite attempts a Glidewire and whisper wire would not advance out sufficiently to allow coronary sinus lead placement. All of the veins were very small and spidery. It was clear that a coronary sinus catheter could not be placed. The original device was left in place."