Ask Dr. Z

How would you code the following? "Contrast was injected through the new catheter opacifying the collecting system. Given persistent leakage of contrast from the catheter skin exit site and possible compression of the catheter by adjacent internal plastic biliary stents, I elected to remove the biliary stents and further upsize the biliary drainage catheter. The catheter was removed over a guidewire common, and over the wire a vascular sheath was advanced into the small bowel. The distal end of one of the indwelling stents was snared and withdrawn into the sheath and removed. The second stent that had become withdrawn into the biliary tree was snared within the biliary tree and removed as well. Then, over a guidewire, a 14 French biliary drainage catheter with additional sideholes cut in the tube was advanced, and the distal pigtail coiled within the small bowel the most proximal sidehole was positioned peripherally in the biliary tree. Contrast was injected through the new catheter. The catheter was flushed with saline, secured to the skin using 2-0 Prolene suture, and pl..."