# Venous Access Codes? Anyone!



## MANCODER (Jan 7, 2009)

Venous Access Codes? Anyone! 

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I work w/ CC docs who are allways in a huge hurry. Unnfortunately they are brief in descriptions for dx. I am looking for a code that will suffice for placing a central line, post cardiac arrest. Not A V code, but rather in general for emergent need for immediate supplu for vasopressors and other critical medications to maintain support in a patients stability. Generally I use the underlying problem such as renal failure or respiratory failure. But many tiimes the doc does not specify the reason outside of emergent need for immediate delivery of meds. Any ideas?


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## ASH527 (Jan 12, 2009)

*Venous Access*

How About Diagnosis 459.81 Venous Insufficiency Unspec And If Using High Risk Medications V58.69.  I Am Throwing These Codes Out There As I Don't Know The Circumstances.  Hope It Helps


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## mad_one80 (Jan 13, 2009)

i dont have many cases where it is undocumented but i usually use the respiratory failure(if it pertains) or the venous insufficiency(459.81)


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## sthibo (Jan 19, 2009)

The circumstances for these encounters will more than likely be varied. Each one has to have a reason for the encounter, this should be your dx code.
CPT code 36556 is for Insertion of Central Venous Catheter age 5 or older.
I hope this helps


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## FTessaBartels (Jan 19, 2009)

*Educate your physicians*

I used to work for Pediatric Critical Care. I trained my doctors to always give me an indication for any procedure (central lines, intubation, chest tubes, etc).  I reminded them that I can only code what they write down. And I can't guess the medical necessity of a procedure if they haven't recorded it. 

If you feel that "emergent need for intravenous delivery of meds" is insufficient to code a diagnosis, find a quiet time to spend one-on-one with one of these physicians to work out possible dx and verbiage that would suffice for both your needs. Then enlist that doctor's help in training the others about the preferred documentation. 

But remember that it will take time for the physicians to internalize this new way (to them) of documenting. Once they do, it will only take an extra 5 sesconds to give you the phrase(s) you need for accurate diagnosis coding. 

F Tessa Bartels, CPC, CEMC


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