# Infusion for thrombolysis



## hwilcox07 (Jan 31, 2014)

Need help with CPT codes for the following:

Indwelling right subclavian central venous line was injected demonstrating no thrombus around catheter with normal appearance to SVC.

Subsequently, a puncture was made of the brachial vein in the antecubital fossa and a guidewire advanced very carefully with venography throughout right arm. There is thrombus throughout right arm up to juncture of subclavian vein and SVC. There was difficulty crossing this juncture possibly related to undrlying stenosis. 

Subsequently, a 50 cm multi sidehole infusion catheter was inserted and directed across juncture of subclavian and SVC and back to antecubital fossa. 10 mg of TPA were instilled into the thrombus to initiate thrombolysis and TPA infusion started at 2 mg/hour. Initial labs unremarkable and will be followed every 6 hours. Patient sent back to ICU.

Study demonstrates thrombosis of the deep venous system of right arm with stenosis at subclavian juncture with the SVC. Thrombolysis initiated. Recheck angiogram ordered for the morning. No evidence of immediate post procedure complication.

I know 37212 for the infusion for thrombolysis but what else can I charge for this? Physician thinks 37212, 36005, 75820, 75827 but I don't agree that is exactly right. Any help please?????

Thanks,


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## TerryFletcherCPC (Jan 31, 2014)

*Thrombolysis*

Hi Holly, 
You are correct on your 37212, but because of the well documented difficulty of manipulating the cath and wire is why the venography was performed. So I would code the 36005 and 75820.26, but he can't have the caval injection as well. That is double dipping. 
You are correct though. Normally, only the 37212 is coded. 
Terry


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## hwilcox07 (Feb 1, 2014)

Thanks so much Terry!!


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