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Yes. Chemotherapy administration and the routine flushing of the device are part of the same procedure. Declotting the device is to address a separate situation that has nothing to do with the chemo administration. CPT guidelines do not address that this is part of the chemotherapy administration codes.

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Coding advice contained in this issue is effective with procedures/services provided after April 30, 2014 unless otherwise noted.

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Patient has an infusion port, port-a-cath or a central venous access device that flushes sluggishly due to obstruction (clot). Instead of saline or heparin being used to irrigate or flush the access device, a thrombolytic agent (tPA) is utilized for irrigation or flushing. How would the instillation of the thrombolytic agent be reported if it were the only service provided, and if it were administered via an intravenous push (IVP), or followed by a lab draw? Which CPT code would be more appropriate to report, 96523, Irrigation of implanted venous access device for drug delivery systems; 36593, Declotting by thrombolytic agent of implanted vascular access device or catheter; or 96374, Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intravenous push, single or initial substance/drug?

If the documentation in the health record supports the presence of a clot, CPT code 36593 may be reported for the declotting of an implanted device or catheter when a thrombolytic agent is used. However, if chemotherapy services are performed, the flushing is inherent and is not separately reported. Please note that routine flushing of vascular access devices with saline or heparin would not be reported separately with certain services (i.e., injection or infusion procedures).

CPT code 96523 may be reported if the patient is seen only for the irrigation/flushing of the vascular access device. Additionally, HCPCS code J2997, Injection, alteplase recombinant, 1 mg, would be reported for the TPA administration.

This code is not to be used for routine flushing of vascular access devices with saline or heparin. This type of flushing is considered inclusive in chemo-therapy services, and is not separately reported.

The Capital Corporation is pleased to announce that Rowley Company ("Rowley") acquired Fleuron En-terprises, Inc. ("Fleuron"), a portfolio company of Ancor Partners. Headquartered in Gastonia, North Carolina, Rowley is an industry leader in the professional window coverings market. This acquisition of Fleuron further enhances Rowley's leadership position in custom decorative drapery hardware industry. Fleuron, a Dallas, Texas based company, primarily operates under three brands: Paris Texas Hardware™, The Finial Company™ and Gould New York. The Capital Corporation was retained by Rowley and its shareholders to serve as Rowley's exclusive financial advisor for this transaction. This transaction serves as another example of The Capital Corpo-ration capitalizing on its decorated 25 years of assisting owners of private companies sell, buy and/or finance their business. About Rowley Company: An industry leader in the professional window coverings market and international distributor of home décor products. Rowley provides drapery and upholstery tools and supplies to resi-dential and professional designers, installers and workrooms for the fabrication of custom window treatments and home décor. Over 15,000 products are available to Rowley's customers and available for same day delivery. For more information about Rowley and its family of designer hardware brands visit www.rowleycompany.com About Fleuron Enterprises: Fleuron Enterprises, Inc. is a leading industry provider in the design and manu-facturing of high-end premium decorative drapery hardware products for the interior design market. Offering a complete line of mid-to-high price point products, Fleuron established three successful brands, The Finial Company, Paris Texas Hardware and Gould New York. Flueron's brands entail collec-tions which are beautifully hand-crafted with artistry and intricate finish details featuring refined, Old World hand finishing techniques. About The Capital Corporation: The Capital Corporation has been helping lower middle market companies achieve their financial objectives since 1991. Our M&A team of professionals have closed hundreds of transactions and leverage our backgrounds from WallStreet and Fortune 500 companies for the bene-fit of our clients. The Capital Corporation is one of seven Merger & Acquisition firms in the nation that has achieved the exclusive IMAP status, allowing for unparalleled access to a global buyer network across three dozen countries. Please visit our website, www.thecapitalcorp.com. Contact: Devin Green, 864.672.8400, dgreen@thecapitalcorp.com