Results 1 to 3 of 3

Intracranial Aneurysm Coil

  1. #1
    Default Intracranial Aneurysm Coil
    Medical Coding Books
    One of our surgeons dictated the following op note on a patient. I am at a loss for how to code this. Any advice would be appreciated.

    DX: Intracranial aneurysm coil extending into the right common femoral artery

    Procedure: Right common femoral cut down with exposure
    Closure of the right common femoral artery puncture site
    Stabilization of the coil fiber to the femoral artery as well as to
    the suture

    A 6 cm oblique incision was made over the right groin area. The incision was carried from the skin down through the subcutaneous tissue. The vertical incision was then carried out. This incision tracked along the existing right common femoral artery sheath. It was then dissected down to the common femoral artery. A 5-0 Prolene pursestring was then placed around the puncture site of the sheath. Within the sheath there was also the intracranial coil of fibers. The sheath was then slowly and carelfully removed over the fiber without pulling on the fiber. A pursestring was then closed to achive hemostasis. Subsequently, the aneurysm coil fiber was then used to wrap and tie down to the external adventitial area of the common femoral artery. Additionally, multiple loops of the fiber were also tied around the suture. Finally, the fiber itself was used as a suture and ties along with the existing suture. Additional sutures were then used to secure the fibers in place to the adventitial of the femoral artery wall. Hemostasis was achieved.

  2. #2
    Default
    Not my specialty but look at 37203.

    Julie, CPC

  3. #3
    Location
    Birmingham, Alabama
    Posts
    889
    Default
    Quote Originally Posted by mmarcum View Post
    One of our surgeons dictated the following op note on a patient. I am at a loss for how to code this. Any advice would be appreciated.

    DX: Intracranial aneurysm coil extending into the right common femoral artery

    Procedure: Right common femoral cut down with exposure
    Closure of the right common femoral artery puncture site
    Stabilization of the coil fiber to the femoral artery as well as to
    the suture

    A 6 cm oblique incision was made over the right groin area. The incision was carried from the skin down through the subcutaneous tissue. The vertical incision was then carried out. This incision tracked along the existing right common femoral artery sheath. It was then dissected down to the common femoral artery. A 5-0 Prolene pursestring was then placed around the puncture site of the sheath. Within the sheath there was also the intracranial coil of fibers. The sheath was then slowly and carelfully removed over the fiber without pulling on the fiber. A pursestring was then closed to achive hemostasis. Subsequently, the aneurysm coil fiber was then used to wrap and tie down to the external adventitial area of the common femoral artery. Additionally, multiple loops of the fiber were also tied around the suture. Finally, the fiber itself was used as a suture and ties along with the existing suture. Additional sutures were then used to secure the fibers in place to the adventitial of the femoral artery wall. Hemostasis was achieved.
    There are a lot of unanswered questions but here goes:

    35226 repair of blood vessel, lower extremity.

    It seems to me that an attempted coil embolization went awry and the coil became dislodged. So, the surgeon opened the groin/leg and removed the sheath but left the coil (perhaps because removal may have caused more damage.?) He then repaired the damaged artery with the pursestring, sutures and coil fibers.

    I hope this helps.
    Danny L. Peoples
    CIRCC,CPC

Similar Threads

  1. dx for malignant intracranial hypertension?
    By she803 in forum Diagnosis Coding
    Replies: 2
    Last Post: 03-26-2013, 03:38 PM
  2. intracranial stent
    By sevans01 in forum Interventional Radiology
    Replies: 0
    Last Post: 01-06-2010, 01:25 PM
  3. Multiple Intracranial Coil Embolizations
    By tcronenw in forum Interventional Radiology
    Replies: 2
    Last Post: 06-03-2009, 03:50 PM
  4. Intracranial aneurysm coil
    By mmarcum in forum General Surgery
    Replies: 0
    Last Post: 05-19-2009, 06:30 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.