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Port-a-Cath

Date: May 7, 2013

Question:

A patient has a port-a-cath, and while in the hospital the catheter is noted to be in the subclavian artery instead of the internal jugular vein. The physician takes the patient to angio to remove the catheter. From the femoral artery he places a catheter in the subclavian and performs an angiogram of the extremity and removes the port-a-cath.  The physician then inflates a balloon for hemostasis. A coder is telling us we can report codes 35475, 36215, 36590, 75710-2659, and 75962-26.  I do not agree with the arterial angioplasty codes, as there was no stenosis. Nor do I agree with code 36590, as it was not in the venous system. I'm thinking this should be an unlisted code along with the diagnostic angio. Can you give me your thoughts?

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