Ask Dr. Z

Please advise on how you would code the following procedure. "Given the large size of the IVC it was not felt safe to deploy the Option filter in an infrarenal location, as there is significant risk for filter migration. Unfortunately, the Birds Nest filter, which is approved for IVC >28 mm, was not available in our department or in the operating room. Subsequently it was decided to place bilateral iliac vein filters. The Option filter sheath was exchanged over a wire for an MPA catheter. The external iliac veins were then selected with the MPA catheter over a Benson wire. Left and right pelvic venogram was then performed. Subsequently, the Option filter was then replaced over a wire to the common iliac veins respectively. The filters were deployed. Post-filter venography demonstrates appropriate location of the filters with their apices at the most distal aspects of the common iliac veins."