The radiologist made use of jugular vein access and advanced the catheter through the vena cava into the hepatic vein. She advanced a needle through the vein wall and into the liver tissue to arrive at a portal vein branch. With a balloon catheter, she dilated the passage the needle created and placed a stent to keep the passage open and allow the blood to flow from the portal system. Documentation shows pre- and post-pressures and calculated gradients as well as hepatic venography. The diagnosis is bleeding esophageal varices caused by alcoholic cirrhosis. What CPT and ICD 9 codes should you apply in this case? Code 37182 is the only CPT code you need to describe inserting the shunt under imaging guidance. Give attention to the part of the code definition that starts with includes' and you will witness that CPT intended this to be an all-inclusive code for tips, procedures, including imaging guidance. For the diagnosis, you should first go for 571.2. After this, add 456.20 for the bleeding esophageal varices. To get more information on CPT and ICD 9 codes online, sign up for a one-stop medical coding website. When you sign up for one, you will get a better idea of what CPT and ICD 9 codes to use in situations such as this. Such a Medical Coding website will offer you official descriptors and guidelines for CPT and ICD 9 codes in addition to updates and instructions to guide a coder in every task and in every specialty. When you get onboard such a website, you will also get to interact with an online community that'll help you in your reimbursement challenges! So it certainly pays to be part of such a website.