# Embolization -  Do we need to add any catheter



## prabha (Sep 17, 2009)

Can anyone help me out with this procedure.My codes are 
      37204
      75894-26
      75898-26 
      Do we need to add any catheter code.Pls confirm whether my codes are correct?
      Procedure.  Translumbar embolization of a type II leak.      

      Clinical information status post EVAR with type II leak.  The
      patient had previously had a translumbar embolization and arterial
      embolization of the inferior mesenteric artery from the SMA.

      Procedure.      
      Informed consent was obtained.  The patient was prepped and draped
      appropriately  after being turned prone.  After infiltration with
      local anesthesia, an 18-gauge needle was advanced into the type II
      leak using the previously placed coils as a marker.

      Contrast injection demonstrates  two contiguous sacs, the
      lowermost of which filled the IMA passed the previously placed
      coils.  No other inflow or outflow was demonstrated.
      An exchange was made for a 4-French Cobra catheter and attempts
      made to catheterize the IMA without success.  Accordingly the
      lowermost sac was filled with 4 6 mm Nester coils and 2 4 mm
      Nester coils to make a dense nest.  A 10-mm coil was placed in the
      uppermost sac.  Contrast injection demonstrated no flow.

      Impression.  Translumbar embolization of  a type II leak from the
      IMA.


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## heiditipherwell (Sep 17, 2009)

What I am getting from that dictation is that they could not place the catheter, therefore you cannot code it.

An exchange was made for a 4-French Cobra catheter and attempts
made to catheterize the IMA *without success*.
Hope that helps.
Heidi


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## dpeoples (Sep 17, 2009)

prabha said:


> Can anyone help me out with this procedure.My codes are
> 37204
> 75894-26
> 75898-26
> ...




My initial  thought is, this is not a transcatheter embolization (37204) but I don't have enough information to give an alternative. What is an EVAR?


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## ciphermed (Sep 17, 2009)

*e*ndo*v*ascular *a*neurysm *r*epair


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## dpeoples (Sep 17, 2009)

ciphermed said:


> *e*ndo*v*ascular *a*neurysm *r*epair




Thanks Anthony. I have coded hundreds of those and don't remember our surgeons using that acronym. 

Based on that, I would code as such:
37204/75894.
36160
and 75898

HTH


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