Wiki Occluded artery coding assistance needed

[hoffmank@centracare]

Dr. is placing an endovascular device in the aortoiliac arteries (the graft is similar to what is placed for aneurysm repair) but he is placing it because the region is occluded, not because there is an aneurysm. I?m not comfortable using 34804 because the description of the code states ?Endovascular repair of infrarenal abdominal aortic aneurysm or dissection; using unibody bifurcated prosthesis? and this repair isn?t being done for that reason.

Here is an excerpt from the procedure note:

The Endologix device, 25 x 80, with [ 13, 40 ]
limbs was then brought in and then snared from the contralateral
side, using snare catheter. That was brought down and seated at
the iliac bifurcation. The stent graft was then opened and the
iliac arteries were then opened as well. The iliac arteries
were then angioplastied again, using 8 mm balloons. Stent graft
was now widely patent. The iliac stents - There was still
residual dissection disease in the right common iliac artery that
later required 2 Express stents, both 857 and 837. After this
was completed, the 7-French sheath was then reintroduced and a
main body extension was then brought in. The 25-55 was then
brought in, deployed below the renal arteries. There was some
encroachment on the right renal artery but no flow disturbance

Findings: occlusive disease of aorta and iliacs


Thoughts? Thanks!

 

[vlh12115]

I'm a novice coder but this is my interpretation of the scenario.
I would review the imaging reports to see if an aneurysm or dissection was present preop because in the body of the op report surgeon states, "There was still residual dissection disease in the right common iliac artery.....". Per the code description, the device is used to treat "aneurysms or dissections.