iamlou
Networker
Can someone please clarify the distinction between these codes when using TPA? I know that when the pulse-spray and removal of the arterial plug is done, code 36870 is appropriate. This is what I'm looking at today and am not sure which one I should use:
Procedure:
Initiation of TPA lysis left brachiocephalic vein.
Catheterogram: Injection of the arterial and venous lumens show thrombus
and/or fibrin sheath adjacent to the tip of the catheter.
A right-sided venogram was performed showing narrowing and possible
thrombus within the right brachiocephalic vein and upper cava.
A multiside hole infusion catheter was placed across the left
brachiocephalic vein and TPA lysis was commenced.
There were no complications.
IMPRESSION: THROMBOSIS LEFT BRACHIOCEPHALIC VEIN FOR WHICH TPA LYSIS WILL
BE PERFORMED
RETROGRADE FLOW FROM LEFT ARM INJECTION UP THE LEFT INTERNAL JUGULAR VEIN
IS NOTED. THE RIGHT INTERNAL JUGULAR VEIN IS NOT VISUALIZED AND THIS
PROBABLY ACCOUNTS FOR THE "SVC SYNDROME SYMPTOMS"
IN ADDITION TO TPA LYSIS OF LEFT BRACHIOCEPHALIC VEIN CATHETER LYSIS WILL
BE PERFORMED.
Any opinions on this are greatly appreciated.
Procedure:
Initiation of TPA lysis left brachiocephalic vein.
Catheterogram: Injection of the arterial and venous lumens show thrombus
and/or fibrin sheath adjacent to the tip of the catheter.
A right-sided venogram was performed showing narrowing and possible
thrombus within the right brachiocephalic vein and upper cava.
A multiside hole infusion catheter was placed across the left
brachiocephalic vein and TPA lysis was commenced.
There were no complications.
IMPRESSION: THROMBOSIS LEFT BRACHIOCEPHALIC VEIN FOR WHICH TPA LYSIS WILL
BE PERFORMED
RETROGRADE FLOW FROM LEFT ARM INJECTION UP THE LEFT INTERNAL JUGULAR VEIN
IS NOTED. THE RIGHT INTERNAL JUGULAR VEIN IS NOT VISUALIZED AND THIS
PROBABLY ACCOUNTS FOR THE "SVC SYNDROME SYMPTOMS"
IN ADDITION TO TPA LYSIS OF LEFT BRACHIOCEPHALIC VEIN CATHETER LYSIS WILL
BE PERFORMED.
Any opinions on this are greatly appreciated.