# Ct-guided cholecystotomy tube placement



## chembree (Aug 4, 2010)

Does anyone have any opinions on how I should code this? 

I am thinking about 75980, 47510?

   CT-GUIDED CHOLECYSTOTOMY TUBE PLACEMENT:

   CLINICAL HISTORY: Cholecystitis, abdominal pain. 

   TECHNIQUE: The risks, benefits and procedure itself were explained to
   the patient, and informed written consent was obtained. The patient was
   placed on table in the supine position. Drape was placed.  

   CT scan was performed to identify the safest place for entrance. This
   area was marked, and this area cleaned and draped in sterile fashion. 1%
   lidocaine was used to anesthetize the overlying soft tissues. Under CT
   guidance, an 18-gauge Chiba needle was inserted through the liver into
   the gallbladder. An Amplatz wire was then curled within the gallbladder,
   tract serially dilated with 5- and 8-French dilators and an 8-French
   pigtail drainage catheter placed in the gallbladder. A total of
   approximately 60 mL malodorous bile was removed. Catheter secured to the
   skin with 2-0 silk and catheter attached to suction bag. The patient
   tolerated the procedure well without postprocedure complication. Sample
   sent to laboratory for evaluation.

   FINDINGS: Initial CT scan demonstrates thick-walled gallbladder with
   some pericholecystic fluid as well as perihepatic free fluid. Subsequent
   imaging demonstrates adequate positioning of the needle and wire within
   the gallbladder. Pigtail catheter was placed, and final image
   demonstrates decompression of the gallbladder.

   IMPRESSION:

   Successful CT-guided cholecystostomy tube placement as described above.


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## HNISHA (Aug 4, 2010)

Its 47490 and 75989

Thanks,
Abdul Saleem CPC


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## chembree (Aug 5, 2010)

Thanks!

Christy, CPC


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