# Help coding Infusion for Thrombolysis and Catherization



## drobinson1 (Sep 28, 2009)

Good morning. I need a little help coding this report. I'm always unsure when it comes to catheters. Should I just code the IVC since the catheter was withdrawn not advanced or should I code where it ended? I was going to go with

37201
36010 or 36247?
75825-26
75820-26
75820-26-59
75896-26

a 21 gauge needle was placed into the popliteal vein clot with ultrasound and fluoroscopic guidance. The tract was dilated to accommodate a 4 French coaxial dilator. An angle Glidewire was advanced into the inferior vena cava. A 5 French sheath was placed and through this, a 4 French angled glide
catheter was advanced to the inferior vena cava. Inferior venacavogram
shows patent IVC. With catheter withdrawn to the mid common iliac vein,
venography shows patent common iliac vein. The catheter was withdrawn to
the upper femoral vein and shows patent iliac vein. The catheter was
withdrawn to the low common femoral vein and venogram shows patent common femoral vein. However when the catheter was withdrawn into the proximal superficial femoral vein, clots within the superficial femoral vein is
demonstrated which ends at the junction with the common femoral vein. The
length of the clot as measured from the tip of the sheath was 29 cm.
Therefore a 30 cm sidehole Cragg McNamara 5 French infusion catheter was
placed with sideholes located within the clotted portion of the vein.
Retavase infusion with concentration of one unit per 100 cc was initiated
at a rate 0.5 units per hour into the Cragg McNamara catheter and another
0.5 units per hour of Retavase was infused into the sheath. The catheter
and sheath were secured to the skin using Tegaderm. The patient was then
transferred to ICU.
IMPRESSION:
1. Thrombus within the left popliteal and superficial femoral vein with
patent common femoral vein and iliac vein.
2. Coaxial infusion with Craig McNamara 30 cm sidehole catheter and 6
French sheath was initiated from the popliteal vein along the entire left
superficial femoral vein thrombus.
3. IV infusion of heparin at 400 units per hour was initiated.


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## Jim Pawloski (Sep 28, 2009)

drobinson1 said:


> Good morning. I need a little help coding this report. I'm always unsure when it comes to catheters. Should I just code the IVC since the catheter was withdrawn not advanced or should I code where it ended? I was going to go with
> 
> 37201
> 36010 or 36247?
> ...



I agree with all of you codes except for the second 75820.  IMO this was an IVCgram, and extremity venogram unilateral, with thrombolysis infusion.
Nice coding!!

Thanks,
Jim


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## prabha (Sep 29, 2009)

With reference to the catheter code I would suggest 36010 rather than 36247.


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## Jim Pawloski (Sep 29, 2009)

prabha said:


> With reference to the catheter code I would suggest 36010 rather than 36247.



You right!  After I sent my thread, I realized that I did not answer that part of the question.  36247 is for the arterial side, not venous.

Thanks,
Jim


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## drobinson1 (Sep 29, 2009)

Thank you for your input. You coders are always so helpful. I really do appreciate it.


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