kbreeden
Contributor
New procedure for this office. Can someone give me some help?
Preoperative Diagnosis: High-grade obstruction of the common hepatic duct.
Procedure: Percutaneous Spyglass-discover with biopsies
Findings: Bile Duct Stricture
Procedure Details: After informed consent was obtained. Patient was in the supine position on the Interventional Radiology fluoro table. Dr. ___ removed the patient's initial internal external drain from the patient's right side. A wire was left in the tract. A 12 French introducer was placed over the wire and maneuvered into the right bile duct. Position was confirmed with fluoroscope. We then used the spy glass discover apparatus and slid it next to the wire through the 12 French catheter into the biliary system. The right bile duct just beyond the introducer appeared normal. At the region of the expected confluence of the right and left bile duct there was bile duct irregularity. The more distal common bile duct appeared normal. We were able to maneuver the spy glass into the duodenum. We gradually pulled back to the area of confluence and bile duct irregularity. We performed 8 spy bite samples. They were sent for histopathological review in formalin. The scope was then removed. Dr. --- completed the procedure by placing a new internal external 12 French drain.
Assessment: Stricture at the area of the bifurcation. Now status post biopsy. Will await pathology and ask the patient to schedule a follow-up office visit.
So our GI physician ran the spy glass the Interventional Rad accompanied with the internal external 12 French drain replacement.
Billing for our GI doc for above. Any advice?
Preoperative Diagnosis: High-grade obstruction of the common hepatic duct.
Procedure: Percutaneous Spyglass-discover with biopsies
Findings: Bile Duct Stricture
Procedure Details: After informed consent was obtained. Patient was in the supine position on the Interventional Radiology fluoro table. Dr. ___ removed the patient's initial internal external drain from the patient's right side. A wire was left in the tract. A 12 French introducer was placed over the wire and maneuvered into the right bile duct. Position was confirmed with fluoroscope. We then used the spy glass discover apparatus and slid it next to the wire through the 12 French catheter into the biliary system. The right bile duct just beyond the introducer appeared normal. At the region of the expected confluence of the right and left bile duct there was bile duct irregularity. The more distal common bile duct appeared normal. We were able to maneuver the spy glass into the duodenum. We gradually pulled back to the area of confluence and bile duct irregularity. We performed 8 spy bite samples. They were sent for histopathological review in formalin. The scope was then removed. Dr. --- completed the procedure by placing a new internal external 12 French drain.
Assessment: Stricture at the area of the bifurcation. Now status post biopsy. Will await pathology and ask the patient to schedule a follow-up office visit.
So our GI physician ran the spy glass the Interventional Rad accompanied with the internal external 12 French drain replacement.
Billing for our GI doc for above. Any advice?