Ask Dr. Z

"We have a patient who presented to IR for an attempted transvenous esophageal varices sclerotherapy. The portal vein, splenic vein, and superior mesenteric veins are known to be occluded. The access site was the right femoral vein. A draining vein for a splenorenal shunt was selected without success in accessing the varices. Catheter was moved superiorly into the inferior phrenic vein (36012) and venogram performed with no access. Catheter withdrawn to find second vein from the femoral vein without success. Venocavogram was then performed at the level of the kidneys and catheters removed." We have findings for the selective vessels, vena cava, and kidneys. What would we use for our imaging codes? I don't think medical necessity was met for the vena cava imaging, but I also cannot find a code for the visceral venous imaging.