Wiki Carotid subclavian bypass with vertebral bypass

cmblocher

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What is the proper procedure code to use in this situation:

This was all done during an endovascular thoracic aortic injury repair. I have only included a small portion of the surgery.
A right carotid subclavin transposition was done (33889). Then a left carotid subclavin bypass with other than vein (35606).
Then this is where my question arises:
"We turned our attention back to the neck. At this point I dissected down onto the left subclavian artery through our supraclavicular incision, dissected out the vertebral. There was a dissection in the left subclavian artery and there was significant bleeding. This was most likely from the placement of our coils from earlier. The artery was oversewn and divided. I transposed the vertebral, took a short piece of saphenous vein, and sewed a graft from the carotid axillary artery bypass to this large vertebral. The vertebral was actually 5-8 mm in diametere. There was concern that this was her major flow to her vertebral circulation.

The physician has the procedure listed as a left carotid subclavian bypass with a left vertebral bypass. I don't know how I code for the vertebral bypass.

Thanks,
Christy
 
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