tci General Surgery Coding Alert - 1999 Issue 3

More Than Brand Name Needed to Correctly Code for Insertion of Vascular Catheter for Venous Access

Scenario: A surgeon is asked to insert a Port-A-Cath for chemotherapy three weeks after a partial mastectomy with axillary node dissection was performed. The primary diagnosis was 459.89 (collateral circulation [venous], any site; phlebosclerosis; venofibrosis), while the secondary ICD-9 was 174.4 (malignant neoplasm of female breast, upper-outer quadrant).In the scenario above, many coders often select the wrong code: Instead of 36533 (insertion of implantable venous access port, with or without subcutaneous reservoir), they sometimes code the procedure with 36488 (placement of central venous catheter [subclavian, jugular or other vein][e.g., for central venous pressure, hyperalimentation, hemodialysis...

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