# Inflation catheter



## prabha (Aug 28, 2009)

What should be the code for this inflation?????????

Procedure and Findings: 
       With the patient in the supine position the left upper abdomen was
       prepped and draped in the usual sterile fashion.  The catheter was
       flushed with sterile saline solution.Approximately 50 cc of
       bilious fluid with clots was aspirated.Contrast examination
       through the catheter demonstrates a nondilated collecting system
       with small intralumenal filling defects consistent with clots.
       The catheter was cut and exchanged over an Amplatz stiff guidewire
       for a seven French sheath.  The sheath was slowly withdrawn
       proximally.  Contrast injection along the tract demonstrates
       opacification of left hepatic artery branches.  In addition, a
       collateral branch from the right hepatic artery appears to
       reconstitute these vessels.  A 5.5-French over-the-wire Fogarty
       balloon catheter was then inflated along the tract between the
       artery and the biliary system for approximately 15 minutes.
       Following deflation, no further communication with the vessels is
       noted.  A 10 French VTCB biliary drainage catheter was then
       replaced across the left biliary system.  Gentle contrast
       administration demonstrates proper catheter positioning.The
       catheter was flushed with saline and aspirated until clear.The
       catheter was sutured to the skin and connected to gravity
       drainage.  The patient tolerated the procedure without incident.

       Impression: Catheter cholangiogram demonstrates persistent
       arterial biliary fistula as described above.  Previously embolized
       vessels are apparently reconstituted via communication with right
       hepatic artery branches.  However, arterial evaluation is limited
       on this examination.

       Successful temporary tamponade of arterial biliary fistula using a
       5.5-French over-the-wire Fogarty balloon as described above.  New
       10 French VTCB biliary drainage catheter was replaced across the
       left biliary tree and the left to external drainage  as described
       above.


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## Jim Pawloski (Aug 28, 2009)

prabha said:


> What should be the code for this inflation?????????
> 
> Procedure and Findings:
> With the patient in the supine position the left upper abdomen was
> ...



I looked through the SIR coding manual, and I did not see anything for the fogarty balloon portion of the exam.  I believe you can only code for the biliary choleangiogram and catheter exchange.


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## Anug123 (Aug 30, 2009)

Hi Prabha,


You can code Unlisted procedure 47999 and fwd the same with description of the procedure to your client with other codes as suggested.


Thanks 
Prabhavathi


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