Varicose Vein Codes

tdesher

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I am having a discrepancy with one of our General Surgeons. I work in an ASC and the office is billing 37700 but the op reports are reading “clusters” so that would default to code 37785, correct? I have posted two examples below. Thank you in advance!


PREOPERATIVE DIAGNOSIS: Varicose veins left lower extremity
POSTOPERATIVE DIAGNOSIS: Varicose veins left lower extremity
PROCEDURE: Ligation and excision of varicose veins left lower extremity

PROCEDURE DESCRIPTION: With the patient in the supine position under adequate general LMA anesthetic, left groin and lower extremity was prepped and draped in the usual sterile manner for surgery. Stepwise incision was made overlying large varicose veins marked by Dr. and the patient prior to the procedure, and taken down through the subcutaneous tissue. Hemostasis was obtained using proximal electrocoagulation. The incisions were extended to the veins and these were removed in their entirety. Multiple veins were removed in clusters. The saphenous vein was ligated and removed. There were two incisions above the knee and five incisions below the knee. After making certain of perfect hemostasis of the operative field, the skin incisions were closed with running suture of 4-0 PDS with wide Steri-Strips. Sterile Kerlix and Ace bandage were applied to the leg at the end of the procedure. All sponge, instrument and needle counts were correct. The patient tolerated the procedure well and was taken to the Recovery Room in satisfactory condition.



PREOPERATIVE DIAGNOSIS: Varicose veins left lower extremity
POSTOPERATIVE DIAGNOSIS: Varicose veins left lower extremity
PROCEDURE: Ligation and excision of varicose veins left lower extremity

PROCEDURE DESCRIPTION: With the patient in the supine position under adequate LMA anesthetic, the entire left lower extremity was prepped and draped in the usual sterile manner for surgery. Stepwise incisions were made overlying large veins marked by Dr. and the patient prior to the procedure and taken down to the subcutaneous tissue. Hemostasis was obtained using proximal electrocoagulation. The veins were removed from the surrounding tissue and removed in clusters. Several perforators were identified in the calf and were ligated and divided. The saphenous veins were also ligated having been identified preoperatively by ultrasound. There were two incisions above the knee and four incisions below the knee. After making certain of perfect hemostasis of the operative field, the skin was closed using running subcuticular suture of 4-0 PDS with wide Steri-Strips. Sterile gauze, Kerlix and Ace bandage were applied to the leg. At the end of the procedure, all sponge, instrument and needle counts were correct. The patient tolerated the procedure well and was taken to the Recovery Room in satisfactory condition.
 
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