Ask Dr. Z

Are codes 36011, 36590, and 77001 correct for the following case? If not, what do you advise? "Known thrombus associated with the central line of port. RUE prepped amd draped. With ultrasound guidance, a small caliber needle was directed into the right basilic vein. Guidewire was directed centrally, needle was removed, and dilators were passed until a 5 French cath could be directed into right subclavian vein. Contrast was injected under fluoroscopy with digital images recorded. Cath was then directed into upper aspect of SVC and advanced into the left innominate vein. Repeat injections of contrast agent performed. Cath was removed and hemostasis achieved. The right anterior chest wall was prepped and draped and anesthetized with local anesthesia. A transverse incision was made over the port and was then removed in its entirety with the attached central line. Pocket was closed, as was skin. Findings: Superior vena cava is chronically occluded with reversal of flow into the azygous system, which is now capacious. A port, which is no longer functional, was removed."