# Fluoroscopy guidance with port-a-cath placement



## bmkardok (Sep 24, 2010)

Hi Everyone,
I have a note and I am not sure if I am coding the claim correctly. This is a new service for me to code and I want to make sure I send the charges out correctly.
36561
76942/26
77001/5926
Service provided in an outpatient hospital setting.

Procedure: The patient was brought to surgery and had IV sedation administered by the anesthesia team. The neck and anterior chest wall were prepped and draped sterilely. Ultrasound was used to locate the left internal jugular vein to verify patency and guide venipuncture. A wire was passed into the right atrium under fluoroscopic guidance. A transverse incision was made on the left anterior chest wall and a pre-fascial pocket develped for the port device. The device and tubing were connected, flushed, and tunneled up to the venipuncture site. They were then cut to appropriate length and passed through an introducer sheath into the central circulation with the tip located at the cavoatrial juction. It aspirated and flushed well. The wounds were closed using layered absorbable technique and dressings were applied. She tolerated this well and was brought from the operating room in good condition.
I appreciate any advise. Thanks Brenda


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## ATMOCH88 (May 15, 2013)

*76492*

HI i am having a similiar issue.  My doctor billed 36561, 77001.26, 76492 and 76492 was denied as unbundled to 36561.  I am not sure if a modifier would be appropriate on this cpt code.


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## jmcpolin (May 15, 2013)

The ultrasound guidance for vascular access is 76937 but they have to document the patency of the vessel.


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