# CT Guided drainage... cpt codes.. help!



## MELJNBBRB

PROCEDURE: CT guided right upper quadrant drainage.

MEDIATIONS: 1% Lidocaine for local anesthesia. Intravenous Versed and
fentanyl for monitored moderate sedation.

FINDINGS:

Informed consent was obtained from the patient.

Sequential axial CT images through the abdomen and pelvis were acquired
and the focal fluid collection within the gallbladder fossa was localized
and a diagnostic transhepatic aspiration and drainage approach was
determined. A timeout was performed. The patient was prepped and draped
in the usual sterile fashion. The skin and subcutaneous tissues were
anesthetized with 1 % lidocaine. Under CT guidance a 22-gauge needle
was advanced into the fluid collection. A 0.018 wire was advanced. Over
the wire a 6 French Neff set catheter was placed. Through the catheter a
.035" wire was advanced. Following tract dilatation a 8.5 French pigtail
drainage catheter was deployed into the fluid collection. Dark bile
appearing fluid was aspirated. The catheter was sutured in place and
connected to a drainage system. Approximately 15 mL of fluid was
aspirated. The collection was aspirated and a sample of fluid was
submitted to the laboratory for bacteriological studies. There were no
complications during the procedure. The patient tolerated the procedure
well and left the radiology department in good condition.

IMPRESSION:

1. Successful CT-guided drainage and catheter placement in the
gallbladder fossa.


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## Rajebpt

47490-if its gallbladder drainage(drainage catheter is placed in gallbladder)
49021-if cholecystostomyis already performed and postoperative collection is drained


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## MELJNBBRB

Thanks so much for your response


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