icd-9 code for ommaya reservoir

Full Answer

What is an Ommaya reservoir?

An Ommaya reservoir is a soft, plastic, dome-shaped device that’s placed under your scalp. It’s about the size of a quarter. An Ommaya reservoir has 2 parts (see Figure 1).

What is the CPT code for a burr hole reservoir?

Thanks! I bill anesthesia for the placement of these reservoirs. For burr hole placement see CPT code 61210. Thanks! You must log in or register to reply here.

What is an Ommaya device?

This device is named after its inventor, a Pakistani neurosurgeon Ayub Khan Ommaya in 1963. [1][2][3] Though initially conceived for delivery of antifungal medications into the cerebrospinal fluid (CSF), this device is commonly used today for chemotherapeutic central nervous system (CNS) delivery and CSF sampling.[4] 

What are the side effects of Ommaya reservoir surgery?

Most people don’t have any side effects after their Ommaya reservoir placement surgery. You may feel a little bump on your head where the reservoir has been placed. This shouldn’t cause you any pain. Can my Ommaya reservoir be taken out?

Is an Ommaya reservoir a shunt?

An ommaya reservoir provides direct access to your cerebrospinal fluid (CSF). An ommaya reservoir, also called an ommaya shunt, is placed during surgery.

Where is an Ommaya reservoir placed?

An Ommaya reservoir is a quarter-sized, soft, plastic, dome-shaped device that is placed under the scalp. It's connected to a catheter (thin, flexible tube) that's placed in one of the ventricles in your brain (see Figures 1 and 2).

What is an Ommaya reservoir used for?

An Ommaya Reservoir is a small, plastic device that is implanted in your brain. It allows your doctor to deliver medicine directly to the fluid around your brain and spinal cord. It also allows your doctor to take samples of the fluid around your spinal cord to test it.

Is an Ommaya reservoir permanent?

Ommaya reservoirs usually aren't removed unless they cause problems, such as an infection.

Is Ommaya reservoir programmable?

An Ommaya drug delivery reservoir was ultimately implanted for intraventricular chemotherapy in addition to a contralateral ventriculoperitoneal (VP) shunt using a programmable valve capable of high resistance, effectively turning the valve off to allow intraventricular CSF dissemination of the chemotherapeutic agents.

What is the CPT code for insertion of a subcutaneous Ommaya reservoir under the scalp for delivery of chemotherapy?

Guest. Anytime we have given chemo via an Omaya reservoir, we have billed teh 96542. It is the more specific admin code and states specifically chemotherapy injection. Hope this helps!

What type of therapy is Ommaya reservoir?

Ommaya reservoir is a highly effective implant that provides long-term access to the cerebrospinal fluid and has simplified administration of antimicrobials, antifungals, antineoplastic, and analgesic medications directly into the brain.

What does an Ommaya reservoir look like?

What is an Ommaya reservoir? An Ommaya reservoir is a soft, plastic, dome-shaped device that's placed under your scalp. It's about the size of a quarter.

How do you pronounce Ommaya reservoir?

0:431:07Pronunciation of the word(s) "Ommaya Reservoir". - YouTubeYouTubeStart of suggested clipEnd of suggested clipPor manera recibo toma el riesgo omaira recibo omaira resbala.MorePor manera recibo toma el riesgo omaira recibo omaira resbala.

What is intrathecal chemotherapy?

Listen to pronunciation. (IN-truh-THEE-kul KEE-moh-THAYR-uh-pee) Treatment in which anticancer drugs are injected into the fluid-filled space between the thin layers of tissue that cover the brain and spinal cord.

What is a rickham reservoir?

An Ommaya Rickham reservoir is a device that can be implanted into the brain. It is used to administer medications and/or to retrieve cerebrospinal fluid samples.

What is Chemoport?

A chemo port is a small, implantable reservoir with a thin silicone tube that attaches to a vein. The main advantage of this vein-access device is that chemotherapy medications can be delivered directly into the port rather than a vein, eliminating the need for needle sticks.

What is an ommaya tap?

An Ommaya reservoir is a soft, plastic, dome-shaped device that's placed under your scalp. It's about the size of a quarter.

When was the Ommaya reservoir invented?

It was originally invented in 1963 by Ayub K. Ommaya, a Pakistani-American neurosurgeon. In January 2017, researchers at University of Texas Southwestern Medical Centre used an Ommaya reservoir to measure the intracranial pressure that is regularly observed in astronauts in zero-gravity conditions.

What is a Rickhams reservoir?

This device is used to deliver ventricular (intra-thecal) chemotherapy via a small reservoir. It is usually sited on the anterior aspect of the head.

Why is lumbar puncture done?

A lumbar puncture (spinal tap) may be done to: Collect cerebrospinal fluid to check for infections, inflammation or other diseases. Measure the pressure of cerebrospinal fluid. Inject spinal anesthetics, chemotherapy drugs or other medications.

What is ommaya used for?

Ommaya reservoir can be used for several procedures where medications are injected into the intrathecal space, CSF is aspirated, or where tumoral cyst fluid is removed.[10]  The major indications are enumerated below.

How is Ommaya surgical?

The surgical site is prepared and then cleaned and draped under aseptic precautions. An inverted U-shaped scalp incision slightly larger than the diameter of the Ommaya reservoir (3.4 cm) is made over the entry point. The center of the incision overlies the Kocher point, located 3 cms lateral to the midline at the mid pupillary line and 1 cm anterior to the coronal suture. [8][9] A pericranial flap is raised to fit the size of the Ommaya reservoir.  A burr hole is made, followed by a cruciate durotomy. Minimal bipolar coagulation of the cortical surface is encouraged. A pial/cortical incision is made, avoiding any surface vessel. Image-guided navigation can significantly improve the accuracy of the target point.[6]  A Dandy needle with an optical tracker is registered with the image guidance system. The trajectory of insertion is as planned via the image guidance system. If done via freehand placement, the trajectory of insertion is placed perpendicular to the calvarium or towards a coronal plane 2 cm anterior to the external auditory meatus and directed towards the contralateral medial canthus.[16]  Entry into the ventricle can be identified by a "pop sensation" and free flow of CSF. The catheter is inserted along the brain needle trajectory. The length of the catheter is cut as estimated according to preoperative imaging (roughly 5 cm to 5.5 cm when measured at the inner table of the calvarium) and attached to the base of the reservoir with a silk tie. This length allows the tip of the catheter to be positioned near the floor of the anterior horn of the lateral ventricle. The correct placement of the catheter can be verified with an image guidance system. The pericranial flap is repositioned over the reservoir and sutured back. The scalp is closed in two layers. Skin marking with Indian ink could be used to identify the correct position of the dome. In the postoperative period, a head CT scan is performed to evaluate the catheter placement and any evidence of hemorrhage.

What is Ommaya catheter?

Ommaya reservoir consists of an indwelling ventricular catheter with a dome-shaped collapsible silicone reservoir port positioned under the scalp . The distal end of the catheter is surgically positioned into the ipsilateral anterior horn with the proximal end connected to the reservoir.

How is the Ommaya reservoir inserted?

For many decades, the Ommaya reservoir was inserted by a freehand technique. If ventriculomegaly is not present, accurate placement of the ventricular end may often be difficult. Multiple attempts through the brain cortex can result in complications such as hemorrhage, intracranial infection, and seizures. Computed tomography-assisted stereotactic placement of the Ommaya reservoir for small or normal-sized ventricles formed the basis for future neuronavigation techniques.[5]  Since then, the insertion of the intraventricular catheter has undergone a major transformation, aided by high-resolution imaging techniques and advances in neuronavigation such as optical tracking frameless stereotactic approach, electromagnetic tracking, frame-based tracking, fluoroscopy-assisted, ultrasound-guided, robot-guided, and endoscope-guided implantations. [6][7]

What is an Ommaya reservoir?

Ommaya reservoir is a ventricular access device for the purpose of repetitive access to the intrathecal space. This device is named after its inventor, a Pakistani neurosurgeon Ayub Khan Ommaya in 1963. [1][2][3] Though initially conceived for delivery of antifungal medications into the cerebrospinal fluid (CSF), this device is commonly used today for chemotherapeutic central nervous system (CNS) delivery and CSF sampling.[4]  The Ommaya reservoir has replaced repeated intrathecal injections (via lumbar or suboccipital puncture) in the administration of antineoplastic drug delivery. This device permits repeated administration of chemotherapeutic drugs without doing a lumbar puncture, allows CSF sampling for the dose titration, and provides consistent intrathecal drug concentrations.

What is the most common complication of a catheter?

Mechanical Failure of Device: In the original case series by Ommaya and Ratcheson, catheter malfunction was the most common complication, involving 23.5% of cases.[3]  However, in present times, catheter malfunction is extremely rare.

What is the preoperative neuronavigation technique?

Image-guided Technique: Preoperative neuronavigation CT scan or MRI with adhesive fiducial markers is performed before surgery. Preoperative imaging is loaded into the image guidance system, followed by a delineation of entry and target points on the surgical planning software. The entry point is through the crown of a gyrus avoiding cortical vessels. The target point is directed to the ipsilateral foramen of Monro. The passive reference frame of the image guidance system is attached to the articulating arm of the Mayfield clamp holder. Fiducial registration is performed, and image-guidance accuracy is checked. [14][15]

Where is the 0JHS33Z?

0JHS33Z Insertion of infusion device into head and neck subcutaneous tissue and fascia, percutaneous approach, for the placement of the Ommaya reservoir portion into the bony pocket of the skull.

Is the AHA coding clinic copyrighted?

AHA CODING CLINIC ® FOR ICD-10-CM and ICD-10-PCS 2020 is copyrighted by the American Hospital Association ("AHA"), Chicago, Illinois. No portion of AHA CODING CLINIC® FOR ICD-10-CM and ICD-10-PCS may be reproduced, sorted in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without prior express, written consent of the AHA.

How to insert Ommaya?

To implant the Ommaya reservoir, your surgeon will start by shaving your head around the implant site. Next, they’ll make a small cut in your scalp to insert the reservoir. The catheter is threaded through a small hole in your skull and directed into a ventricle in your brain. To wrap up, they’ll close the incision with staples or stitches.

What is an Ommaya reservoir?

An Ommaya reservoir is a plastic device that’s implanted under your scalp. It’s used to deliver medication to your cerebrospinal fluid (CSF), a clear fluid in your brain and spinal cord. It also allows your doctor to take samples of your CSF without doing a spinal tap.

How to tell if Ommaya is placed?

Once the Ommaya reservoir is placed, you’ll feel a small bump on your head where the reservoir is.

What is the first part of CSF?

The first part is a small container that’s shaped like a dome and is placed under your scalp. This container is connected to a catheter that’s placed in an open space within your brain called a ventricle. CSF circulates within this space and provides your brain with nutrients and a cushion. Share on Pinterest.

What are the signs of infection after a staple?

Be sure to tell your doctor about any signs of infection, such as: a fever. headaches. red ness or tenderness near the incision site. oozing near the incision site. vomiting.

Do Ommaya reservoirs need maintenance?

Once you’ve healed from the procedure, you can return to all of your normal activities. Ommaya reservoirs don’t require any care or maintenance.

Can you remove an Ommaya reservoir?

Ommaya reservoirs usually aren’t removed unless they cause problems, such as an infection. Though at some point in the future you may no longer need your Ommaya reservoir, the process to remove it carries the same risks as the process to implant it. Generally, removing it isn’ t worth the risk.