# Picc



## tristate (Feb 18, 2009)

Would you code 77001, 75827 and 36569?  According to CPT code 75827 can be coded along with 77001 if a formal extremity venogram is performed from separate venous access.   Does that mean the venogram has to be performed on a different vein?   Thank you!!

PICC LINE INSERTION

Informed written consent was obtained after risks, benefits and possible complications were explained to the patient. Under aseptic technique, using fluoroscopic guidance, right antecubital vein was localized. Next, the area was prepped in aseptic fashion.  Under fluoroscopic guidance, using micropuncture technique, antecubital vein along the lateral aspect was accessed.  Over the guide wire, 4-French PICC line was inserted with the tip in the right atrium.  45 cm was inserted.  Following the insertion, superior vena cavagram was performed which demonstrated excellent position and function of the PICC line.

IMPRESSION: 

Successful fluoroscopic guided peripheral PICC line insertion with insertion of 45 cm length without any immediate complications.


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## Kimberfly (Feb 18, 2009)

Yes - the venogram has to be from a different puncture site and it has to be for more than verifying the final location. All of the venography and fluoro described in your report are included in 77001. 

I would normally code a venogram with a PICC only if they went in to try to use that vein, ran into a problem and injected contrast to diagnose the problem. Then, they usually use a separate puncture, like in the other arm, to place the PICC line.


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