Trendale
Guest
Hello,
I need help coding this. I beleive it is 36556. Should I code the ultrasound as well? How do you determine if it is tunneled or non-tunneled?
Indication: Hypotensive. Venous access needed for vasopressor infusion
( what dx would I use for that?)
There was exaggerated distention of the external juglar and veins of the head and neck. Using the sonosite ultrasound, the right IJ was easily identified and the carotid artery was easily identified. The patient was then prepped and draped in the usual sterile fashion. Using appropriate sterile technique, gowns, gloves, mask and cap, the patient was positioned properly. The right internal juglar vein was easily entered using the sonosite ultrasound. A wire was passed through the needle and into position. The needle was removed. The wire could not be advanced all the way through the SVC and met persistent obstruction at approximately 9 cm from the skin. A small incision was made and a dilator passed over the wire. A triple lumen central venous line was then passed over the wire through the IJ. It was advanced to 9cm and, at that point, could not be adbvanced further. The wire was then removed.Again, attempts were made without success in advancing the triple lumen cath any further than 9cm at the skin.There was good blood return from all ports. The cath was easily flushed with saline. The cath was then secured in place at several sites. The vasopressors were instilled through the distal port and instructions given to maintain vasopressors visa distal pot only.
Thanks!
I need help coding this. I beleive it is 36556. Should I code the ultrasound as well? How do you determine if it is tunneled or non-tunneled?
Indication: Hypotensive. Venous access needed for vasopressor infusion
( what dx would I use for that?)
There was exaggerated distention of the external juglar and veins of the head and neck. Using the sonosite ultrasound, the right IJ was easily identified and the carotid artery was easily identified. The patient was then prepped and draped in the usual sterile fashion. Using appropriate sterile technique, gowns, gloves, mask and cap, the patient was positioned properly. The right internal juglar vein was easily entered using the sonosite ultrasound. A wire was passed through the needle and into position. The needle was removed. The wire could not be advanced all the way through the SVC and met persistent obstruction at approximately 9 cm from the skin. A small incision was made and a dilator passed over the wire. A triple lumen central venous line was then passed over the wire through the IJ. It was advanced to 9cm and, at that point, could not be adbvanced further. The wire was then removed.Again, attempts were made without success in advancing the triple lumen cath any further than 9cm at the skin.There was good blood return from all ports. The cath was easily flushed with saline. The cath was then secured in place at several sites. The vasopressors were instilled through the distal port and instructions given to maintain vasopressors visa distal pot only.
Thanks!