# Femoral venous sheath for dialysis?



## Robbin109 (May 29, 2012)

*Femoral venous sheath for dialysis? 36559?*

Placment of a femoral venous sheath for dialysis?


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## dpumford (May 30, 2012)

You did not give alot to go on....But if this is a non-tunneld catheter placement,  take a look at 36556, these are normally for temporary access.

If a tunneld catheter is done take a look at a Ash cath 36558 if flouroscopy is done also use 77001-26.  This can be more long term until a Permanent access site is created.

Hope this helps...  Read the information under _*Central Venous Access Procedure*_, there is some good info that will help you!


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## Robbin109 (May 30, 2012)

Here is the report:


Procedure: Placement of femoral veneous sheath for dialysis.

Diagnosis: End Stage Renal Disease

An attempt was made to place the sheath through the right internal jugular vein, however, I could not gain access into the jugular vein. Right groin was prepped and access was gained in the right femoral vein using a modified Seldinger technique and a Quinton cathether was then placed w/o difficulty. Good flow was established. the sheath was then flushed. The sheath was then sewn into place. We will initiate dialysis as soon as possible.


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## dpeoples (May 30, 2012)

Robbin109 said:


> Here is the report:
> 
> 
> Procedure: Placement of femoral veneous sheath for dialysis.
> ...



I would code 36556 for this, assuming the patient's age is greater than 5.

HTH


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## Robbin109 (May 30, 2012)

I meant  36569....Why not 36569 since it's peripherally inserted?


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## dpeoples (May 30, 2012)

Robbin109 said:


> I meant  36569....Why not 36569 since it's peripherally inserted?



Found under the heading of Central Venous Access Procedures in the CPT book you will see descriptions of what constitutes centrally inserted vs peripherally inserted. 

Central (jugular, subclavian, femoral vein or IVC)
Peripheral (basilic or cephalic vein)

HTH


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## Robbin109 (May 30, 2012)

Thanks...I haven't encountered any of these before...I need to read up.


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