MelBarclay
Guest
I don't know why Tesio catheter removal/replacements are always confusing to me. I'm thinking 36581 but for a Tesio would this be billed 2 x along with 77001 for the fluoroscopy guidance? See the operative course below. Any feedback is greatly appreciated.
OPERATIVE COURSE: Patient was taken to the operating room, timeout called, everyone agreed. Right neck was prepped and draped. The old catheter would not flush adequately. This was prepped and draped and local placed. We then cut the catheter and then pulled this retrograde back up where it was pulled out of a small 1 cm right IJ incision. Next, two guidewires were placed down and the old catheter removed. All of this was done under fluoroscopy and the wires were in proper position at the atriocaval region. The Tesio catheters, both the red and blue Tesio catheters, were placed over the wires and the wires were removed. A tunneling device was used to tunnel 10 cm to the infraclavicular region on the right chest wall after a small incision was made in the skin after local placed. These catheters were easily flushed with nonpulsatile dark venous blood drawback. Skin incisions closed with 4-0 nylon. Excellent results obtained. No complications. Counts correct. Fluoroscopy confirmed proper position. Chest x-ray pending. They may use dialysis tonight.
OPERATIVE COURSE: Patient was taken to the operating room, timeout called, everyone agreed. Right neck was prepped and draped. The old catheter would not flush adequately. This was prepped and draped and local placed. We then cut the catheter and then pulled this retrograde back up where it was pulled out of a small 1 cm right IJ incision. Next, two guidewires were placed down and the old catheter removed. All of this was done under fluoroscopy and the wires were in proper position at the atriocaval region. The Tesio catheters, both the red and blue Tesio catheters, were placed over the wires and the wires were removed. A tunneling device was used to tunnel 10 cm to the infraclavicular region on the right chest wall after a small incision was made in the skin after local placed. These catheters were easily flushed with nonpulsatile dark venous blood drawback. Skin incisions closed with 4-0 nylon. Excellent results obtained. No complications. Counts correct. Fluoroscopy confirmed proper position. Chest x-ray pending. They may use dialysis tonight.