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Thread: Thoracic Aorta Exploration

  1. #1
    Join Date
    Apr 2007

    Default Thoracic Aorta Exploration

    AAPC: Back to School
    I am stumped on this one could anyone help please? I'm thinking 33401 but not sure!

    PREOPERATIVE DIAGNOSIS: 1) Blunt trauma. 2) Thoracic aortic abnormality. 3)
    Fractured right kidney.

    POSTOPERATIVE DIAGNOSIS: 1) Blunt trauma. 2) Thoracic aortic abnormality. 3)
    Fractured right kidney.


    INDICATIONS: 11-year-old boy involved in blunt trauma
    which resulted in a liver laceration, a right kidney laceration and a
    question of a descending thoracic aortic injury by CT scan. He is being
    taken to the Operating Room by the nephrologist for a right nephrectomy and
    the request was made to assist with vascular control as well as exploration
    for evaluation of the thoracic aortic injury.

    FINDINGS: No significant injury of the distal thoracic aorta could be
    identified. Proximal vascular control of the aorta was obtained to
    facilitate right nephrectomy.

    TECHNICAL DESCRIPTION: With the patient on the table in the supine position,
    an exploratory laparotomy was performed per Dr. R and Dr. R from
    P. My attention focused on exposing the distal thoracic
    aorta. The triangular ligament was divided and the lateral lobe of the liver
    was retracted, exposing the thoracic aorta. This was dissected free from the
    surrounding tissues with a combination of electrocautery and blunt
    dissection. At the level of the diaphragm the exploration around the aorta
    continued for approximately 5 cm without a significant aortic injury
    identified in the area suggested by preoperative CT scan. Once I was
    convinced that there was no significant aortic injury, I then encircled the
    aorta with an umbilical tape and tourniquet. Next the urologist proceeded to
    explore the right kidney. As they began to enter the area of vascular
    injury, I provided proximal control by occluding the thoracic aorta at the
    level of the diaphragm. They then proceeded with their nephrectomy.
    Following this procedure the tourniquet was removed from the aorta
    uninjured. The remainder of the procedure was completed by the nephrologist.
    Last edited by llowry; 04-19-2011 at 02:09 PM.

  2. #2


    Hello: I would look at code 33330 or even 33310 with dx of 901.0. I would research more to make sure correct but those are my first thoughts. Report did not state if bypass was used or not...

    33401 requires bypass there is cutting of the valve leaflets and the aorta is quickly closed and clamps removed. the entire operation must be done in no more than five minutes to prevent brain damage. Per the Cardiothoracic Surgery Coding Companion.. So I would not use 33401.

    Hope this helps!


  3. #3


    Have you looked at 35761?

  4. #4
    Join Date
    Apr 2007

    Default Thank you

    I've looked @ all of those and will review them again!
    Thank you for your help!!

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