# Unsucessful IVC filter retrieval



## kdoughty (Feb 24, 2015)

How would you code this?  Should I bill for the attempted retriveal with the -53 or cath placement and vena cavogram?

After informed consent was obtained the patient was taken to the angiogram suite.  The right side of the neck was sterilely prepped and draped.  A time-out protocol was observed.  Intravenous sedation was provided to the patient.
Under ultrasound guidance the right internal jugular vein was punctured with an 18 gauge needle.  A guide wire was inserted followed by a 5 Fr. sheath.  The wire was advanced into the IVC and positioned distal to the IVC filter.  The sheath was then exchanged for a long retrieval sheath.  An inferior vena cavogram was performed.  A number of loop snares and wires and catheters were then employed in multiple attempts to snare and retrieve the IVC filter.  A balloon was also used to try to move and reposition the IVC filter to facilitate snare placement.  
All of these efforts were unsuccessful.  The IVC filter appears densely adherent to the wall of the IVC.  
Therefore the filter was left in position and is deemed irretrievable.  
TIA


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## j.monday7814 (Feb 24, 2015)

I would use 37193 with the modifier 53 since he made a reasonable attempt to remove it.


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