# Groshong Catheter Placement



## LIVE2CODE (Jul 13, 2017)

I am confused as to rather or not I should code placement of Groshong catheter with CPT code 11981 instead of the with 36556 for TKA Explant and Placement of Antibiotic Spacer 27488.


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## AlanPechacek (Jul 14, 2017)

No.  The Groshong Catheter placement (36556) is for establishing long term IV access for IV antibiotic treatment of the infection, in this case the knee.  It is placed into the Subclavian Vein of the neck by tunneling under the clavicle.  The 27488 for removal of the knee prosthesis for the knee infection and placement of a cement spacer would include whatever antibiotics are incorporated/mixed in(to) the cement.  The 11981 code is in the Skin and Integumentary Section of surgical procedure codes and applies to placement of a drug delivery implant under the skin, i.e. subcutaneous, and not into deeper tissues, so its use is not warranted.  It is not the same as a Groshong Catheter or an Antibiotic Spacer. 

Hopefully this helps you.

Respectfully submitted, Alan Pechacek, M.D.


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## LIVE2CODE (Jul 17, 2017)

I am inquiring about this because a catheter was placed superior lateral intra-articularly and secured with sutures.  Even with the cement mixture of antibiotics. I assume for additional antibiotic treatment postoperatively.   

Thank you for your response



AlanPechacek said:


> No.  The Groshong Catheter placement (36556) is for establishing long term IV access for IV antibiotic treatment of the infection, in this case the knee.  It is placed into the Subclavian Vein of the neck by tunneling under the clavicle.  The 27488 for removal of the knee prosthesis for the knee infection and placement of a cement spacer would include whatever antibiotics are incorporated/mixed in(to) the cement.  The 11981 code is in the Skin and Integumentary Section of surgical procedure codes and applies to placement of a drug delivery implant under the skin, i.e. subcutaneous, and not into deeper tissues, so its use is not warranted.  It is not the same as a Groshong Catheter or an Antibiotic Spacer.
> 
> Hopefully this helps you.
> 
> Respectfully submitted, Alan Pechacek, M.D.


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## AlanPechacek (Jul 19, 2017)

Thank you for clearing up where your physician placed the "Groshong" catheter, i.e. putting it percutaneously into the joint rather than into the Subclavian Vein.  I don't know if it was placed for drainage purposes only, or whether he was going to use it for periodic flushing & irrigation of the joint using its external portals.  I am going to guess the latter.  As such, I would consider his placing it into the joint as being "included" in the joint procedure 27488, not a separate procedure to be coded.

Hope this helps.

Alan Pechacek, M.D.


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