Wiki Direct injection venogram and venous ablation

hwilcox07

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Would I code the following with 37241???

Procedure: Direct injection venogram and percutaneous venous ablation

History: Cavernous angioma of the gastrocnemius muscle left leg

After explaining procedure, alternatives and risk, consent was given. The patient was placed in the right lateral decubitus position and under general endotracheal anesthesia. Using ultrasound guidance a single puncture was made into the largest venous channel. Contrast was injected and demonstrates ,multiple serpiginous channels involving the gastrocnemius muscle. After approximately 8cc of contrast there was some opacification of a portion of the posterior tibial vein. No sign of contrast extravasation.

Subsequently a second syringe was hooked to the needle and 5.5 cc of absolute alcohol were injected until there was no further flow or blood return in this portion of the cavernous angioma.

A second puncture was then made in the nore inferior aspect of the angioma and the injection demonstrates multiple serpiginous venous channels in the lower part of the mass. Additional 4.5 cc of absolute alcohol were injected into this portion of mass while holding pressure on the venous outflow.

Injection was stopped when there was no longer prompt blood return. Pressure applied. Orders written. Patient admitted for 23 hr observation.

Impression: Successful direct puncture vein ablation for treatment of cavernous angioma.

Preprocedure diagnosis: Cavernous angioma
Postprocedure diagnosis: Same

Thanks :)
 
For 37241, it would have to be thru a catheter, not direct puncture...you could go with the unlisted vascular surgery code (37799)....would need to fix a fee...
 
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