# IVC filter with PICC line



## Shirleybala (Aug 22, 2008)

Hi mindys,
Please help me to code this senario IVC filter with PICC line.

      The patients right arm was prepped and draped in the usual sterile
      manner and locally anesthetized with one percent lidocaine.   The
      right brachial vein was accessed under ultrasound guidance with a
      micropuncture set.  Exchange was made for a 4 French omni flush
     catheter which was advanced to the SVC, inferior vena cava and
      into the left iliac vein.  Contrast was injected and digital
      subtraction angiography was performed of the inferior vena cava.
      Measurements were also obtained of intra vena cava.

      Findings:

      There is normal venous anatomy, no anomalies are identified.  The
      inferior vena cava is under 28 mm in diameter.  Renal vein inflow
      is identified bilaterally.

      Intervention:

      The Simon nitinol antecubital introducer sheath was advanced into
      the inferior vena cava.  The Simon nitinol IVC filter was then
      deployed below the level of the renal veins.  Completion
      angiography was performed, demonstrating good filter position
      below the renal veins.

      An exchange was then made for a 7F peelaway sheath.  A 6F triple
      lumen lumen Solo Power PICC line, which was cut to 42 cm in length
      was positioned with the tip in the upper portion of the right
      atrium.  The catheter was flushed with Heplock solution, sutured
      in place and a sterile dressing applied.  No immediate
      complications.

      Impression:

      1.  Infrarenal nitinol IVC filter placed via right brachial vein
      approach.

      2.  6 French triple lumen 42 cm long Bard Solo Power PICC left in
      place at the puncture site, with tip in upper portion of right
      atrium.  No immediate complications.


----------



## MLS2 (Aug 22, 2008)

let's see...75825-59, 75940, 37620, and if the patient is over age 5 I am going with 36569 (PICC).

do you know if the PICC and the filter were placed for different reasons?  If they were done for different reasons via 2 separate passes, you could add the 36010 with a 59 on the PICC.


----------



## Shirleybala (Aug 24, 2008)

Thank you for your reply


----------



## Shirleybala (Aug 26, 2008)

Next i will ask that doubt only thankyou


----------

