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Co-surgeon coding help!

  1. #1
    Location
    Melbourne, Florida
    Posts
    124
    Unhappy Co-surgeon coding help!
    Medical Coding Books
    Co-surgeon coding help!!
    Help with coding for DR. B>> we would like to use :
    34802-62
    34812-62
    36200
    75952
    I apprecitate any feedback, thank you in advance.

    SURGEON (CO-SURGEON) #1 DR. A's REPORT

    DATE OF SERVICE: 01/20/2010

    PREOPERATIVE DIAGNOSIS: Abdominal aortic aneurysm.

    POSTOPERATIVE DIAGNOSIS: Abdominal aortic aneurysm.

    PROCEDURE: Bilateral femoral artery exploration and repair, abdominal aortic
    stenting.

    SURGEON: **DR. A*** M.D.

    CARDIOLOGIST/CO-SURGEON:**Dr. B***

    ANESTHESIA: General.

    OPERATION: The patient was taken to the operating room and prepped in the usual manner with DuraPrep and draped in the usual manner. An oblique
    incision was made over the common femoral artery incising the common femoral vessel with the _____ . Using the Seldinger technique, we entered the common femoral arteries bilaterally, passed a pigtail catheter over Benson wires in the suprarenal aorta, performed an aortogram and Dr. B came in, we upgraded our sheaths from 7-Frenchs, and he continued to deploy the main body of the stent and its limb and ballooned the stent and its limbs, obtained a completion arteriogram. We had bilateral large sheaths in both groins.
    Patient had been heparinized, and we removed them and closed the arteriotomies in a running 5-0 Prolene cardiovascular suture, closed with the subcutaneous with 2-0 Vicryl subcuticular stitch and skin clips.

    _________________________
    DR.A******, MD


    CARDIOLOGIST (CO SURGEON # 2) DR. B's OPERATIVE REPORT

    PREOPERATIVE DIAGNOSIS: Abdominal aortic aneurysm.

    POSTOPERATIVE DIAGNOSIS: Abdominal aortic aneurysm.

    PROCEDURE: Endovascular closure/exclusion of an abdominal aortic aneurysm.

    SURGEON OF RECORD: Dr. A

    CARDIOLOGIST OF RECORD: Dr. B

    OPERATIVE REPORT: Patient was prepped and draped in the usual sterile fashion after which Dr. A performed surgical cutdowns of both femoral regions and sheaths were placed. An angiogram was performed, showed and confirmed the infrarenal abdominal aortic aneurysm. Next, the sheaths were exchanged for large sheaths on both groins. The Gore Excluder device was then deployed. It was a 26 x 14 x 12 via the right common femoral region into the abdominal aortic region. On the contralateral limb, an 18.5 x 9.5 cm length contralateral limb was placed. They were inflated with the usual balloon and followup angiography showed no evidence of endoleaks with good apposition.
    After which, Dr. A performed the closure.

    IMPRESSION:
    1. Infrarenal abdominal aortic aneurysm.
    2. Successful closure of the infrarenal abdominal aortic aneurysm with Gore
    Excluder device. The main trunk was a 26 x 14 x 12 and the contralateral limb
    was an 18.5 x 9.5.
    3. No endoleaks or complications noted.


    _________________________
    DR. B***, MD
    Denise Gilrane-Pillow, CPB

  2. #2
    Location
    Des Moines, IA
    Posts
    36
    Default
    In Dr. A's report, he/she states the aortogram was performed, and then Dr. B came in, and completed the deployment.

    I would give bilateral cath placements (and cutdowns) to Dr. A. Otherwise, I would agree with what you have coded for Dr. B.

    Hope that helps.

    Michelle Hanson, CPC

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