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Transnephric Venous Fistula Embolization with Gelfoam, 37241

Date: Feb 28, 2014

Question:

What can we code for the following?  "A nephrostogram was performed on the left through the existing nephrostomy tube. The left nephrostomy tube was then exchanged over a stiff angle glide wire for a new nephrostomy tube and anchored in place. An antegrade nephrostogram was then performed on the right through the existing nephrostomy tube. The nephrostomy tube was exchanged over a stiff angle glide wire for a new nephrostomy tube. A follow-up nephrostogram shows fistulization from the lower pole calix of the right kidney to small branch of the right renal vein with rapid opacification of the main right renal vein and inferior vena cava. The nephrostomy tube was exchanged over stiff angle glide wire, which was passed down the right ureter. A peel-away sheath was then placed over the wire into the right renal pelvis, and a C1 gliding catheter was advanced into the lower pole calix and in the fistula to the vein. The fistula was then embolized with multiple gelfoam torpedos. A follow-up nephrostogram shows occlusion of the fistula without oppacification of the renal vein. A new nephrostomy tube then placed."

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