sudhakaraa
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PERATION PERFORMED: Right leg composite graft between the right external iliac artery and the right anterior tibial using PTFE (polytetrafluoroethylene)*and vein.
A groin incision was made through which the previous graft was opened. There was an evidence of purulent material in that groin; therefore, we decided to go more proximal as an inflow source. An incision was made in the right inguinal area above the ligament through which the posterior peritoneum was exposed and the right external iliac was identified and dissected from the surrounding tissue. At this time a lateral tunnel was made between the external iliac artery incisions down to the leg. The distal and anterior tibial artery was identified through a small incision on the leg just above the ankle. About two segments were identified and dissected. The short saphenous vein was harvested through separate incision from the back of the same leg. This was done in the routine fashion. The good segment of the vein was harvested and prepared for the bypass by ligating the branches. One end of 6 mm PTEF graft then was sutured in an end-to-side fashion to the right external iliac artery. The graft was then passed through the tunnel on the lateral aspect of the leg all the way down into leg. An incision was made just around the knee area. The distal end of the graft then was sutured in an end-to-end fashion to the reversed saphenous vein graft. The whole graft was then passed through the rest of the tunnel down to the incision on the leg. The distal end of the vein then was sutured in an end-to-side fashion to the anterior tibial artery just above the ankle.
Can anyone please help to code?
can we code 35665, 35666 and 35681?
Thanks in advance.
A groin incision was made through which the previous graft was opened. There was an evidence of purulent material in that groin; therefore, we decided to go more proximal as an inflow source. An incision was made in the right inguinal area above the ligament through which the posterior peritoneum was exposed and the right external iliac was identified and dissected from the surrounding tissue. At this time a lateral tunnel was made between the external iliac artery incisions down to the leg. The distal and anterior tibial artery was identified through a small incision on the leg just above the ankle. About two segments were identified and dissected. The short saphenous vein was harvested through separate incision from the back of the same leg. This was done in the routine fashion. The good segment of the vein was harvested and prepared for the bypass by ligating the branches. One end of 6 mm PTEF graft then was sutured in an end-to-side fashion to the right external iliac artery. The graft was then passed through the tunnel on the lateral aspect of the leg all the way down into leg. An incision was made just around the knee area. The distal end of the graft then was sutured in an end-to-end fashion to the reversed saphenous vein graft. The whole graft was then passed through the rest of the tunnel down to the incision on the leg. The distal end of the vein then was sutured in an end-to-side fashion to the anterior tibial artery just above the ankle.
Can anyone please help to code?
can we code 35665, 35666 and 35681?
Thanks in advance.