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Port removal – help

Am I coding this correct?

36595-59
36590
36010
77001-59

1. Selective catheterization of SVC from right femoral vein
2. Endovascular retrieval of fractured infusaport from right atrium using en snare device
3. Intraoperative fluoroscopy
4.Removal of left subclavian infusaport

Using 21 gauge microstick needle the right femoral vein was cannulated. Guidewire was passed up into the IVC. The right groin was then dilated first with a 6-fench sheath and then i put a 11 french short sheath. I was able to pass the sheath up in to the SVC. I was able to pass the En snare device in attempt to snare the catheter which was in the distal SVC and the distal tip of the catheter appeared to be against the sidewall and I could not snare the tip of the catheter. At this time, I used multiple oblique views as well to help with visualization.

At this time, I decided then to try gooseneck catheter. A 25mm gooseneck catheter was then deployed, but the sheath was only 55cm and I could barely deploy the tip of the snare right at the level of the catheter, but I could not snare it.

I then placed the En snare device and finally was able to snare the distal end approximately 2-3 cm from the catheter. The snare catheter was then easily pulled down out of the heart in to the IVC into the right iliac vein. After putting tension on snare device, I was able to pull the sheath and complete catheter out under fluoroscopic guidance.The entire embolized catheter was removed and this was inspected and was later sent to pathology for gross only.

At this time, attention was then directed removing the patient’s left chest infusaport itself. An incision was made with a 11-blade scalpel and then electrocautery was used to dissect down to the port itself. The port was freed up. I then removed the entire catheter under fluoroscopy and the wounds were irrigated out.

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