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Wiki Intraoperative hemorrhage-aborted BKA code?

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cbutsko

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Trying to figure out the best possible way to code this. Surgeon attempted a BKA but had to abort due to intraoperative hemorrhage. Op report is as follows:

Anterior and posterior skin incisions were outlined with a marking pen. The anterior skin incision was marked to be 15 cm below the tibial tuberosity and extended medially and laterally towards the edges of the gastrocnemius muscle. The cephalad anterior skin incision was made. Immediately after making this incision there was significant venous bleeding to be secondary to his known history of venous congestion. The bleeding was controlled after clamping and tying off multiple bleeding superficial, dilated, tortuous veins. The bleeding was significant. Any time any of the incision was extended, more tortuous veins were encountered and more significant bleeding occurred. A tourniquet was briefly applied to aid in completion of the surgery, but further exacerbated venous congestion. Tourniquet was taken down. After over an hour, and approximately 1000 mL of blood loss, and only approximately 15cm of the cephalad portion of the incision made, the decision was made to abort the procedure out of an abundance of caution, and in the patient's best interest. All bleeding was controlled with suture ligation and electrocautery.

I could just use the BKA code with a 52 modifier but I can't help wondering if there isn't something more fitting. I've looked at 35226 but would that apply in an instance of multiple blood vessels? Everything else I've looked at, as far as I can tell, is for post op hemorrhage. I thought I'd try posting here to see if anyone had any better suggestions.

Thanks in advance!
 
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