# Direct Puncture Sclerotherapy



## claning (Dec 12, 2011)

Good Morning Coders 
 I have a procedure I have not coded before and need help. The patient had Direct Puncture Sclerotherapy (3 injections) of the nasal/pharyngeal area for venous malformation, see partial report:

An ENT retractor was placed for the procedure.  Endoscopes
were used to visualize the extent of the vascular lesion
involving the nasal/oropharynx.  Once this was done, a
total of 3 micropuncture needles were placed into the
vascular malformation at various locations.  There was no
significant bleeding.   Subsequently, each needle was
injected with contrast dye to insure proper position within
the vascular malformation.  Direct-puncture sclerotherapy
was then performed using 2% Ethamolin.  The sclerosing
agent was mixed in a 50:50 solution with contrast dye for
visualization.  Approximately 4 ml of Ethamolin was
injected under fluoroscopic guidance.

I am leaning towards 36470 (per SIR, AMA not just for leg). Would that be billed x3? Or an unlisted coded? Any other codes?

Thank you for your input!

carol


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## donnajrichmond (Dec 13, 2011)

Yes 36470 can be used for a site other than leg, but it also says "single vein".  That's not what you did.  
I would code 37799.


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## claning (Dec 13, 2011)

thanks Donna. I think I will value it close to 36470 x3? Does that sound right?


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## Grintwig (Dec 13, 2011)

What about 36469? Single or multiple injections of sclerosing solutions, spider veins face


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## claning (Dec 13, 2011)

I saw that, but this was sclerotheray for a venous hemangioma/malformation...I didn't see any RVU's attached to that, but it seemed like a lesser procdure than he did. Thanks for the suggestion  unlisted are my fav! not!


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