# Thrombin/gelfoam slurry injection



## prabha (Jul 2, 2009)

How to code the below procedure?Can we code it as an E/M code


Procedure: Thrombin/Gelfoam slurry injection through subcutaneous
      tunnel of indwelling right chest wall tunnel dialysis catheter.

      The patient is status post
      tunnel dialysis catheter exchange. The patient
      returns with persistent and intermittent oozing from the
      subcutaneous tunnel.  Referred for catheter evaluation for
      persistent oozing.

      On physical examination, no active bleeding through the
      subcutaneous tunnel is visualized, however, there is a small
      amount of subcutaneous hematoma with expression of blood clot.

      The right chest subcutaneous tunnel site was then prepped and
      draped in usual sterile fashion.  The skin and subcutaneous
      tissues were anesthetized with 2% lidocaine solution.  Injection
      of a slurry composed of 5000 units of thrombin, normal saline
      solution, and Gelfoam pledgets into the subcutaneous tunnel was
      then performed.  Injection was performed while simultaneously
      compressing the right internal jugular vein.  The skin entry site
      was covered with a sterile dressing.  The patient tolerated the
      procedure well and left the department in stable condition.

      Impression: Thrombin/Gelfoam slurry injection into subcutaneous
      tunnel of indwelling right chest wall tunneled dialysis catheter,
      as above.


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## MLS2 (Jul 13, 2009)

I was thinking an unlisted code for this...


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## vkhusid (Dec 18, 2009)

*Thrombin*

Can anyone help me please...
How do we bill for Thrombin in office settings? One of our physicians did a surgery on a patient, patient had post-op bleading and came back to the office. Doctor took thrombin from ambulatory surgery and they will bill us for it. I need to know how do we bill that? Can we bill at all in post op period?

Thanks


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