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Is 96420 billable with this note if the physician is doing the infusion himself? thanks! PROCEDURE(S): Right Hepatic Arterial Chemoembolization HISTORY: Neuroendocrine Tumor, Metastatic to Both Lobes Liver, Status Post Right Hepatic Arterial Chemoembolization in July 17, 2009 and Left Hepatic Arterial Chemoembolization August 27, 2009. Recent CT Scan Shows New Tumor Growth in the Right Lobe of the Liver. INDICATION: Control of Tumoral Growth MEDICATIONS: Fentanyl 200mcg; Midazolam 3mg; Cisplatin 100 mg I-A; Adriamycin 50 mg I-A; Mitomycin-C 10 mg I-A; Ethiodol 10 ml I-A CONTRAST: Omnipaque 350, 90 ml COMPLICATIONS: None. TECHNICAL: Following informed consent, and verification of the appropriate patient identification and procedure to be performed, the right groin was sterilely cleaned, prepped, and draped. Via a right common femoral artery puncture a 5-French vascular sheath was placed. Through this a 5-French RC-1 catheter was advanced into the superior mesenteric artery, and superior mesenteric arteriography was performed. The catheter was advanced into the distal SMA, beyond the origin of the replaced right hepatic artery (second order), and superselective superior mesenteric arteriography including portal phase imaging was performed. Confirmation of patency of the portal vein is necessary prior to chemoembolization. This confirmed such. The catheter was advanced into the celiac artery, and celiac arteriography was performed. The catheter was advanced into the replaced right hepatic artery, which arose from the SMA (second order), and superselective right hepatic arteriography was performed. With the catheter in this position, chemoembolization was performed by the intra-arterial administration of the above-mentioned chemotherapeutic agents immediately followed by the intra-arterial administration of 4 cc of 300-500 micron Contour-SE particles. Follow-up hepatic arteriography was performed showing reduction of flow in the right hepatic artery distribution by 30%. Flow was maintained in the superior mesenteric artery and its branches. The catheter was removed and hemostasis obtained at the puncture site. FINDINGS: There are several vague hypervascular masses throughout the liver consistent with metastatic neuroendocrine tumor. Chemoembolization was performed as described. There is variant celiac anatomy with a replaced right hepatic artery arising from the superior mesenteric artery. The superior mesenteric artery and its branches, superior mesenteric vein, portal vein, and left and right portal branches are normal. IMPRESSION: Right hepatic arterial chemoembolization as described.