# 36010



## Shirleybala (Oct 16, 2008)

Hi,
In this senario should i have to code 36010 twice with a 59 modifier, please advice.

      Preliminary ultrasound of the left groin was performed
      demonstrating patency of the left common femoral vein. The
      patient's left groin was prepped and draped in the usual sterile
      manner and locally anesthetized with 1 percent lidocaine.  The
      left common femoral vein was accessed with a micropuncture set.
      Limited venography was performed confirming patency of the left
      common iliac vein.  An omni flush catheter was then  passed into  
      the inferior vena cava.  Contrast was injected and digital
      subtraction venography was performed of the inferior vena cava.

      Findings:

      There is thrombus within the inferior vena cava.  Normal venous
      anatomy is identified.  Renal vein inflow is identified
      bilaterally.  The IVC is of normal caliber.

      At this point the left common femoral vein access was abandoned
      and ultrasound was performed of the right internal jugular vein,
      demonstrating patency.  The right neck was prepped and draped in
      the usual sterile manner and locally anesthetized with 1%
      lidocaine.  The right internal jugular vein was accessed with a
      micropuncture set, under real-time ultrasound guidance.  A
      sonographic recording was made for patient's medical record.  An
      Omni flush catheter was then advanced into the inferior vena cava.
      Contrast was injected and digital subtraction venography was
      performed of the inferior vena cava.

      Findings: Again note is made of thrombus within the inferior vena
      cava.  Normal venous anatomy is identified.  Renal vein inflow is
      identified bilaterally.  The IVC is of normal caliber.

      The puncture site was dilated, and a Gunther Tulip introducer
      sheath was placed.  The Gunther Tulip IVC filter was then deployed
      below the level of the renal veins.  Completion venography was
      performed, confirming filter position below the renal veins and
      above the thrombus.


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## MLS2 (Oct 20, 2008)

I agree with 36010 billed twice.


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## Mouf1818 (Nov 25, 2008)

I would say yes also because it was done from 2 separate access sites and you code for the furthest the catheter went in each instance.


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