# uterine artery cath placement



## prabha (Jul 16, 2010)

Can anyone get me the possible codes for the below procedure???????


42-year-old G2P1001 35 weeks 6-day gravid female
       with placenta previa and possible placenta accreta.  Patient
       referred for bilateral uterine artery catheter placement prior to
       cesarean section


The bilateral groins were prepped and draped in the usual sterile
       fashion.

       After the administration of local anesthesia and under ultrasound
       guidance, access into the right common femoral artery was obtained
       a 21-gauge micropuncture set.  A Bentson wire was placed through
       the transition dilator and advanced centrally into the abdominal
       aorta.  The transition dilator was then exchanged for a 5-French
       vascular sheath.

       After the administration of local anesthesia and under ultrasound
       guidance, access into the left common femoral artery was obtained
       a 21-gauge micropuncture set.  A Bentson wire was placed through
       the transition dilator and advanced centrally into the abdominal
       aorta.  The transition dilator was then exchanged for a 5-French
       vascular sheath.

       A 4-French glide Berenstein catheter was then advanced over the
       wire and through the right common femoral artery sheath and
       positioned within the abdominal aorta.  The catheter and wire were
       then used to select the contralateral left common femoral artery.
       The Bentson wire was then exchanged for a Glidewire and the
       catheter and glide wire were used to select the left internal
       iliac artery.

       A gentle injection of contrast confirmed good positioning within
       the left internal iliac artery and identified the origin of the
       left uterine artery.  Using roadmap technique, the catheter and
       Glidewire were used to select the left uterine artery.  The
       catheter was advanced over the wire and positioned within the mid
       left uterine artery.  A gentle injection of contrast confirmed
       good positioning of the distal tip of the catheter within the mid
       left uterine artery.

       A 4-French glide Berenstein catheter was then advanced over the
       wire and through the left common femoral artery sheath and
       positioned within the abdominal aorta.  The catheter and wire were
       then used to select the contralateral right common femoral artery.
       The Bentson wire was then exchanged for a Glidewire and the
       catheter and glide wire were used to select the right internal
       iliac artery.

       A gentle injection of contrast confirmed good positioning within
       the right internal iliac artery and identified the origin of the
       right uterine artery.  Using roadmap technique, the catheter and
       Glidewire were used to select the right uterine artery.  The
       catheter was advanced over the wire and positioned within the mid
       right uterine artery.  A gentle injection of contrast confirmed
       good positioning of the distal tip of the catheter within the mid
       right uterine artery.

       The catheters and sheaths were attached secured to the skin with
       20 Prolene suture and attached to pressure flush bags.  Sterile
       dressings were then applied over the skin entry sites.

       Impression:
       Bilateral uterine artery catheterizations as described above.


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## drsnpatil (Jul 16, 2010)

*Contributor*

36247, 36247-59, 75736, 75736-59.
Side Mod-RT & LT also valid with procedure codes.
It helps you.



prabha said:


> Can anyone get me the possible codes for the below procedure???????
> 
> 
> 42-year-old G2P1001 35 weeks 6-day gravid female
> ...


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## HNISHA (Aug 1, 2010)

prabha said:


> Can anyone get me the possible codes for the below procedure???????
> 
> 
> 42-year-old G2P1001 35 weeks 6-day gravid female
> ...



I would prefer 36247, 36247-59 only. IMO there is no diagnostic angiography performed hence 75736 not applicable.


Thanks,
Abdul Saleem CPC


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## preserene (Aug 2, 2010)

I agree with HNISHA and drspatil the codes 36247 LT 36247 RT but for -59 -documentation should support different session, different site or organ system................. .What if I append -51 as appropriate rather than -59
I need your validation please. Imay be wrong but I want to know why am I wrong?


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## HNISHA (Aug 2, 2010)

Based on the Insurance we can use either RT LT or 59 modifiers.

With reference to 51, 59 modifiers
(51-Multiple procedure
59-Distinct procedural service)

IMO the procedures performed here are similar but different anatomical sites. Hence we have appended 59 modifier.

Hope this make sense....

Thanks,
Abdul Saleem CPC


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