# Tunnel Peritoneal Cath (Pleurx) Exchange?



## Chlrtrep (Nov 11, 2016)

Need assistance on determining a code for the procedure. This is a two year old tunneled pluerx cath for long term treatment of ascites. Tunneled pleurx catheter was exchanged for a new pleurx cath. I am only aware of a removal code not an exchange code.

report below.

CLINICAL HISTORY: Ascites, leaking Pleurx catheter. A Pleurx catheter is been in place for 2 years.
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COMPARISON: None
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PROCEDURE SUMMARY:
1. Informed consent.
2. Moderate sedation was administered under my direct supervision. Total sedation time 45 minutes.
3. The existing Pleurx catheter was removed over 0.035 inch wire after the cuff was dissected free of the soft tissue.
4. A new Pleurx catheter was placed over the wire and advanced into the right upper quadrant. Contrast was injected to confirm no leakage from the Pleurx tunneled tract.
5. The catheter was secured to the skin with silk suture. The tunnel tract was secured with Vicryl suture.
6. Approximately 1 L of peritoneal fluid was drained with a vacuum bottle.
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PROCEDURE FINDINGS AND DETAILS:
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. The right abdomen was then prepped and draped in the usual sterile fashion.
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2% lidocaine was used anesthetize the skin overlying the thorax catheter. The catheter was cut. The existing Pleurx catheter was removed over 0.035 inch wire after the cuff was dissected free of the soft tissue. A new Pleurx catheter was placed over the wire and advanced into the right upper quadrant. Contrast was injected to confirm no leakage from the Pleurx tunneled tract. The catheter was secured to the skin with silk suture. The tunnel tract was secured with Vicryl suture. Approximately 1 L of peritoneal fluid was drained with a vacuum bottle.
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Hemostasis was obtained with manual pressure. The patient tolerated the procedure well without complication. Orders as appropriate were written in the chart. The patient was transferred to the recovery area in stable condition.

1. Successful right upper quadrant Pleurx catheter exchange.
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RECOMMENDATIONS FOR FOLLOW UP AND PLAN:
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1. Routine Pleurx catheter care. If catheter continues to leak a new tunnel need to be created.
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## kmgauthier (Nov 16, 2016)

I would use 49423 and 75984 for the S&I.


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