HI,
Need help
This patient is a 30-year -0ld white female with longstanding history of varicose vein disease who had previously been treated with ablation of the greater saphenous vein. Unfortunately she had persistent filling of the venous collateral circulation through a branch of the saphenous bulb. In adddition to the subjective symptoms I would note that the patient has not been experiencing relief with support hose as she does spend all day on her feet as she is a radiology technician.
The procedural note: After induction of anesthesia her left lower extremity was prepped and draped in the usual sterile fashion. I began at the proximal extent of the disease which was 4 to 6cm below the inguinal crease. I made a small stab incision and identified the tributary that was the feeder vessel of the vessels distal to that point. I dissected it proximally 2 to 3 cm and applied a clip and then transected the vein. I stripped it distally over a distance of approximately 3 cm and then made a series of stepladder incisions down the course of the varicosity avlulsing the vein in segments and the associated tributaries. He goes on to say he he did 10 stab incisions.
Besides the 37765 for the stab phlebectomy, is there a code I should be adding for ligating the collateral venous tributary? If so, what?
Any help is greatly appreciated.
Marci
Need help
This patient is a 30-year -0ld white female with longstanding history of varicose vein disease who had previously been treated with ablation of the greater saphenous vein. Unfortunately she had persistent filling of the venous collateral circulation through a branch of the saphenous bulb. In adddition to the subjective symptoms I would note that the patient has not been experiencing relief with support hose as she does spend all day on her feet as she is a radiology technician.
The procedural note: After induction of anesthesia her left lower extremity was prepped and draped in the usual sterile fashion. I began at the proximal extent of the disease which was 4 to 6cm below the inguinal crease. I made a small stab incision and identified the tributary that was the feeder vessel of the vessels distal to that point. I dissected it proximally 2 to 3 cm and applied a clip and then transected the vein. I stripped it distally over a distance of approximately 3 cm and then made a series of stepladder incisions down the course of the varicosity avlulsing the vein in segments and the associated tributaries. He goes on to say he he did 10 stab incisions.
Besides the 37765 for the stab phlebectomy, is there a code I should be adding for ligating the collateral venous tributary? If so, what?
Any help is greatly appreciated.
Marci