# Picc Line



## Shirleybala (Aug 5, 2008)

Hi,
Can you suggest me how to code this senario, brachial vein puncture venography done,basilic vein puncture, cephalic vein puncture picc line was placed.All are done in *Right side *only.
Do we have to code separately or we have to code only picc line.

      Under real time ultrasound guidance, the medial right *brachial
      vein was punctured with a 21 gauge needle.*  A  0.018 inch
      guidewire was inserted although the wire could not be advanced
      without resistance.   Contrast injection with limited venography
      was performed demonstrating extravasation.

      An additional 8cc of intravenous contrast was administered
      peripherally on the right after which unsuccessful flouroscopic
      guided needle access was *attempted in the right basilic vein.*

*Ultrasound-guided right cephalic vein access *was then successfully
      attempted after administration of subcutaneous lidocaine.  Through
      the 21 gauge needle, a 0.018 inch guidewire was inserted.  A 6
      French triple lumen power PICC SOLO catheter was inserted through
      the peel-away sheath and advanced to the chest.  The catheter tip
      was positioned at the junction of the superior vena cava and the
      right atrium.


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## Shirleybala (Aug 27, 2008)

*Suggestion*

Hi mindys please give your suggestion for the above senario

Thanks
Shirley CPC, CPC-H


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## MLS2 (Aug 27, 2008)

36569:  Insertion of peripherally inserted central venous catheter (PICC), without subcutaneous port or pump; age 5 years or older 

(if the pt. is 5 or older)

I didn't see mention of any US images being permanently recorded, so I wouldn't do the 76937.


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## Shirleybala (Aug 27, 2008)

The physician has attempted in brachial vein  an venography don know we will code a 36005  with PICC


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## MLS2 (Aug 28, 2008)

You would need a 59 on the injection (36005)


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## Hariharan (Sep 6, 2008)

Hi,

As per documentation I go with 36569,36005-59 and 75820 for brachial and cepahalic veins respecitively,I will not  code for basilic vein attempted procedure,since there is much more documentation to support to use 36005.


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## MLS2 (Sep 8, 2008)

I agree


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