Ask Dr. Z

Hi Dr. Z, The physician performed a right and left heart cath with left Vgram and coronary angiography and aortic arch angiography. Because the patient had a history of IVC ligation, the physician performed a hand injection through the venous sheath in her right groin in an effort to identify her venous anatomy to faciliate the right heart cath. This revealed a narrow venous structure region with continuous flow present into a more normal appearing inferior vena cava adjacent to the entrance of the right atrium. He suspected that this is a well developed collateral that has developed as a result of ligation. He was able to navigate the right heart catheter through this vessel into the heart. My codes are as follows - 93460, 93567, but I question if I should use 75825-59. I decided against 36010 first because there is an edit, and I didn't feel that was distinct from the catheter placement used for the cardiac cath portion. I'm thinking the 75825-59 is in fact appropriate but would greatly appreciate your fine wisdom!! Thanks!