# Fibrin sheath disruption



## donnagullikson (Mar 1, 2017)

I'm struggling coding fibrin sheath disruptions.


FIBRIN SHEATH DISRUPTION

How would I code this? Following discussion, written informed consent was obtained for the procedure.  The right groin was sterilely prepped and draped.  Right femoral TempCath was exchanged for a 10 French sheath.  The inferior vena cava was empirically dilated to low pressure with a 12 mm balloon to disrupt any potential fibrin sheath.  The sheath was exchanged for a 24 French Schon TempCath which was placed with the tip at the level of the IVC.

Thanks,


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## mdawn (Mar 11, 2017)

donnagullikson said:


> I'm struggling coding fibrin sheath disruptions.
> 
> 
> FIBRIN SHEATH DISRUPTION
> ...



My IR book says, when a physician uses a balloon catheter to break up a fibrin sheath, this should be reported with codes 36595 & 75901.


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## pgardner (Aug 31, 2020)

another request for help coding fibrin sheath disruptions:
initial procedure was tunneled central venous catheter exchange with fluoroscopic guidance which was completed.  Diagnostic venography done due to suspected stenosis or occlusion right atrium followed by svc  followed by aspiration of heparin within the indwelling catheter limited performed venogram.  Injection demonstrated fibrin sheath balloon disruption. no equipment used, no specimens removed. no separate access.  Dr Z indicate 2019 society recommendation is to report with 38999 or 37799 for disruption of a fibrin sheath with a balloon, which was a change from prior guidance.  Do anyone have any updates or other coding advice?  Thanks,


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## such78 (Aug 31, 2020)

pgardner said:


> another request for help coding fibrin sheath disruptions:
> initial procedure was tunneled central venous catheter exchange with fluoroscopic guidance which was completed.  Diagnostic venography done due to suspected stenosis or occlusion right atrium followed by svc  followed by aspiration of heparin within the indwelling catheter limited performed venogram.  Injection demonstrated fibrin sheath balloon disruption. no equipment used, no specimens removed. no separate access.  Dr Z indicate 2019 society recommendation is to report with 38999 or 37799 for disruption of a fibrin sheath with a balloon, which was a change from prior guidance.  Do anyone have any updates or other coding advice?  Thanks,


I code as 37799 via same access


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