# Ultrasound-guided aspiration and sclerotherapy



## chembree (May 29, 2012)

CLINICAL HISTORY:  Recurrent abdominal wall seroma.

ULTRASOUND-GUIDED ASPIRATION AND SCLEROTHERAPY

TECHNIQUE:  The risks, benefits and procedure itself were explained to the patient and informed written consent was obtained. The patient was placed in the supine position. The risk of incomplete sclerosis of the lesion as well as skin damage was discussed with the patient. Under ultrasound guidance, a Yueh catheter was inserted into the fluid collection. Total of 200 cc of bloody fluid was removed. Subsequently, 10 cc of lidocaine was placed within the collection. This was aspirated. Subsequently, 10 cc of absolute alcohol was placed and extended throughout the cavity. The catheter was removed. The patient tolerated the procedure well.

FINDINGS:  

1. Ultrasound demonstrates a very large heterogeneous fluid collection with internal septations measuring approximately 5.4 x 2.2 x 5.5 cm, however complete dimensions are difficult to ascertain.
2. Needle access documented.
3. Complete aspiration of fluid.
4. Appropriate infusion of sclerotic agent without complication.

IMPRESSION:  Successful ultrasound-guided seroma drainage with sclerotherapy as described above.


I am looking at 
 10140
 17999
 76942
Can anyone offer any guidance for this procedure? The hospital is using use 49083 and 11900. We are the radiologist.


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## dpeoples (May 30, 2012)

chembree said:


> CLINICAL HISTORY:  Recurrent abdominal wall seroma.
> 
> ULTRASOUND-GUIDED ASPIRATION AND SCLEROTHERAPY
> 
> ...



This is an interesting case. I could make a reasonably good argument for either code set. My suggestion is to mirror what the hospital is using. The only caviat is I would like to know how deep the seroma was in the abdomin? That might make a difference to me.

HTH


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## Rita Bartholomew (May 31, 2012)

I would go with 10160 instead of 10140 because of the method described.  I agree with your 17999 for the alcohol ablation and 76942 for the guidance.


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